TODAY'S DATE: __________________________________ #of Guests_____________________
CREDIT CARD #____________________________________EXP______________V-CODE______
NAME: _________________________________COMPANY NAME:______________________
DELIVERY ADDRESS: _____________________________________________________________
ORDER:___________________________________________________________________________
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CUSTOMER NAME _____________________________________________________________
PHONE: WK/____________________HM/CELL_______________________FAX______________
PICK UP TIME______________________DELIVERY TIME_____________________________
EVENT DATE: ________________________ EVENT TIME: ____________________________
A Minimum Delivery Charge of $20.00 Will Be Added to Your Total
LAMBRUSCO’Z TO GO
TELEPHONE 918-496-1246 FAX 918-496-2199
1344 E. 41ST STREET, TULSA, OK 74105
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