Delivery Order Form CONTACT INFO: Name: Phone Number: Email Address: DELIVERY INFO: Name of Venue: Address of Venue: Date: Time needed: Name of contact at Delivery: Phone number of contact at Delivery: Special Delivery Instructions: The customer may choose to receive their meal on china plates for $5/plate. By using china plates, a kosher diner will feel more comfortable in a social setting. Please specify date and time of when each item will be served. All deliveries must have a two-hour window. No deliveries will leave Shallots before noon unless otherwise arranged. Item Quantity Packaging (select one) Day/Meal DisposableChina DisposableChina DisposableChina DisposableChina DisposableChina DisposableChina DisposableChina OTHER INSTRUCTIONS: Shallots Bistro uses a courier service that varies in rates depending on gas prices and distances. Downtown deliveries are approximately $45. For custom orders, please contact Kristin Curtis @ Kristin@shallotsbistro.com Please fill out form attached credit card authorization form and fax back to 847-677-3420 or email to email@example.com. Credit Card Information Type of Card:VisaMasterCardAmerican ExpressOther Credit Card Number: Card Security Code: Expiration Date:---010203040506070809101112/---201620172018201920202021202220232024202520262027202820292030 Name On Card: Billing Address: Printed Name: Daytime Telephone: Signature: Date: I understand that my order is not complete until I receive verbal or email confirmation from Shallots Bistro.*Must check box before your order will be processed. Thank you! Reservations Make Reservation Order Online Assemble Order Hours Sunday 10:00AM to 9:00PM Last Seating Monday - Thursday 11:30AM - 9PM Last Seating Friday Closed Saturday 1 ¼ Hour After Sundown To 11:00PM Last Seating We are always interested in accommodating our customers. Please contact us if you have any questions regarding our hours.