Fax: 503-763-6773   Voice: 503-587-7031   www.millcreekstation.com   millcreekstation@comcast.net

Order lunch off of our cafe menu and fax this form to 503.763.6773

Please place orders no later than 2:00 PM the day PRIOR to service.

Order 10 lunches and the 11th lunch is free! What a deal!

17% service charge will be added to all deliveries. 

Call for soup and salad offerings. If no side is indicated we will automatically send Kettle Chips.
NAME ORDER SIDE CHOICE COOKIE BEVERAGE
  1. ____________________________________________________________________________________
  2. ____________________________________________________________________________________
  3. ____________________________________________________________________________________
  4. ____________________________________________________________________________________
  5. ____________________________________________________________________________________
  6. ____________________________________________________________________________________
  7. ____________________________________________________________________________________
  8. ____________________________________________________________________________________
  9. ____________________________________________________________________________________
10.

____________________________________________________________________________________
FREE__________________________________________________________________________________
DELIVERY ADDRESS:________________________________________________PHONE__________________________
DELIVERY TIME:________________________  CONTACT PERSON:___________________________________________

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