March Wednesday Night Dinner Reservation
If the reservations for your family are the same for each week, use one form. If not, fill out one form per person.
I'd like to make a reservation for: (check all that apply)
March 3 - Chicken & Rice, Mixed Vegetables, Salad, Rolls, Dessert, Drinks
March 10 - Mexican: Tacos, Beans, Cheese & Chips, Salad, Fruit, Dessert, Drinks
March 17 - Baked Chicken, Broccoli Casserole, Rice, Cornbread, Dessert, Drinks
March 24 - Baked Pasta, Salad, Garlic Bread, Dessert, Drinks
I will receive my meal by:
Pick up and I am willing to deliver to someone else
Please arrange for my meal(s) to be delivered
I will eat in the J O Smith Building
Number of adult meals needed (11-64 years old) ($7)
Number of children or senior meals (4-10 yrs or 65+) ($5) Family max $22
How will you pay for your meals?
I will pay online at
I will mail a check to P. O. Box 541 Zip 39818
I will bring payment to the office.
I will pay each week at the door. (exact change or check please)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service