Example Order Request (Do Not Fill Out) This is Not a Real Form. Thank you.
This is an example form that is not to be filled out. Please do not fill out. Two weeks prior to your event, a form that has been designed for your party weekend will be sent to you. Thank you so much.
Please choose your food, drink, and cake options from the available items below. With the exception of our pizza, which comes from Juliano's on Rte 1, additional food and drink is usually available from your Scramble Party Host during your party. Your party includes unlimited commercially filtered water, ice, cups, lids, and straws as your party kids will get thirsty. We also recommend selecting a large carbohydrate bowl for quick nibbling when they grab their water! City of Alexandria taxes are included in our prices.
Email address *
What is your name (First, Last)? *
Your answer
What is the day and time of your party?
10 a.m.
11 a.m.
12 p.m.
1 p.m.
2 p.m.
3 p.m.
4 p.m.
5 p.m.
Other
Friday
Saturday
Sunday
Other
Would you like any pizza (feed guide for kids)?
0
1
2
3
4
5
6
7
8
Cheese (16" feeds 4 - 12) $18
Pepperoni (16" feeds 4 - 12) $20
Would you like any of our sandwich platters (brioche rolls with selection of fillings - specify in next question) $36. Tell us first how many platters of 18 sandwiches you would like.
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If you are ordering a sandwich platter, now tell us what sandwiches you would like (multiples of 3 - 1 selection = 18 rolls, 2 = 9+9, 3 = 6+6+6). If you have ordered more than 1 platter, tell us in the comments at the end what sandwich mix you want.
This filling
Cheese (not Caprese)
Lettuce
Tomato
Onion
Homemade Aioli
Turkey
Ham
Caprese (Mozzarella & Tomato)
Would you like one of our fresh fruit platters (feeds about 15, seasonal fruit selection) $26?
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Would you like one of our fresh vegetable platters (feeds about 15, seasonal vegetables with ranch or hummus options) $24?
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0
1
2
3
4
Number of veggie platters
Ranch dipping bowls @ $2 each
Hummus dipping bowls @ $6 each
Would you like any bowls of chips (feeds about 12)?
0
1
2
3
4
Tortilla chips/Salsa $10
Vegetable straws $8
Puffs $6
Pita chips & hummus $12
Would you like any drinks?
0
1
2
3
4
5
6
Honest Juice - various flavors, 10 cartons $9
Coffee urn (minimum 12 cups) $20
Coke - 12 bottles $20
Diet Coke - 12 bottle $20
Flavored Perrier - 12 bottles $20
Gatorade - various flavors, 24 bottles $18
Large water - 24 bottles $12
Small water - 48 bottles $12
White milk - 12 boxes $18
Chocolate milk - 12 boxes $18
Any Scramble mini-cupcakes (12) $8
0
1
2
3
4
5
Vanilla/vanilla with sprinkles
Chocolate/vanilla with sprinkles
Red velvet/vanilla
Chocolate/raspberry
Chocolate/vanilla
Vanilla/chocolate
Phone number *
Your answer
E-mail
Your answer
Questions and comments
Your answer
A copy of your responses will be emailed to the address you provided.
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