Lenten Fish Fry Diners 2018

Please fill out this form and click submit.
You will receive a confirmation
E-Mail shortly.

Email

*

This address will receive a confirmation email

Number of Adult Dinners at $10 each

0 ($0) 1 ($10) 2 ($20) 3 ($30) 4 ($40) 5 ($50) 6 ($60) 7 ($70) 8 ($80) 9 ($90) 10 ($100)

Amount

Number of Kids Dinners (5 to 11yrs) at $5 each

0 (0) 1 ($5) 2 ($10) 3 ($15) 4 ($20) 5 ($25) 6 ($30) 7 ($35) 8 ($40) 9 ($45) 10 ($50)

Amount

Number of Senior Dinners (60+) at $8 each

0 (0) 1 ($8) 2 ($16) 3 ($24) 4 ($32) 5 ($40) 6 ($48) 7 ($56) 8 ($64) 9 ($72) 10 ($80)

Amount

Add AYCE to how many Dinners at $4 each

0 (0) 1 ($4) 2 ($8) 3 ($12) 4 ($16) 5 ($20) 6 ($24) 7 ($28) 8 ($32) 9 ($36) 10 ($40)

Amount

Cheese Pizza Meal $5.00 each

0 ($0) 1 ($5) 2 ($10) 3 ($15) 4 ($20)

Amount

EXTRA slice Pizza $2.00 each

0 ($0) 1 ($2) 2 ($4) 3 ($6) 4 ($8)

Amount

Small Cole slaw

0 ($0) 1 ($1) 2 ($2)

Amount

Large Cole Slaw 1lbs

0 ($0) 1 ($4) 2 ($8)

Amount

Mac Cheese 1lbs

0 ($0) 1 ($5) 2 ($10)

Amount

Soda Pop 2 liter

0 ($0) 1 ($2) 2 ($4)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit.
You will receive a confirmation
E-Mail shortly.

Close