Cafe Reservation Form for __________ ( date) Entree: _______________________________ _______________________________________.....$(price?) Drink Choices: ____ Ice Water.............................................FREE ____ Coffee................................................... $ .50 ____ Hot Tea................................................ $ .50 SODAS ARE SOLD IN CANS: ____Diet Caffeine-Free Pepsi...............$ .50 ____Pepsi...........................................................$ .50 ____Ginger Ale..............................................$ .50 Dessert: _____________________ _______________________________________.....$______ STAFF Please complete #1, 2, & 3 below: #1. I will eat during Lunch: __ 7 __ 6 __ 8 #2. During the lunch checked above, I want: ___ to eat in CAFE 103; ___ to pick-up my take out order; ___ you to deliver my lunch to Rm#_______ #3. My name is:_____________________ To assure you will have a lunch on Thursday: Please return this form to Rm. 103 by 2:15 PM on Tuesday, (List date)

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