GROCERY ORDER FORM *Availability varies by location. - Veterans Affairs

GROCERY ORDER FORM

Order Ahead for Pick-Up

Visit your local canteen for more information

Customer Information:

on dates and times.

Name: ______________________________________

Phone #: ____________________________________

Date: _______________________________________

*Availability varies by location.

Qty Frozen Meat

___Chicken Breast (raw) 5 pound bag

$17.49

___Chicken Breast (cooked) 5 pound bag

$21.99

___Ground Beef 80% Lean (raw) 5 pound roll $24.99

___Chicken Tenders (raw) 5 pound bag

$19.99

___Boneless Chicken Wings (raw) 5 pound bag $19.99

___Smoked Pulled Pork (cooked) 5 pound bag $30.99

___Smoked Pork Loin (cooked) 4 pounds

$21.99

___Breakfast Sausage (raw) 2.5 pound roll $8.99

___Bacon (raw) 1 pound

$5.99

Qty Frozen Entrees, Vegetables, and Sides:

___Meat Lasagna Tray serves 8-12

$16.95

___Macaroni and Cheese Tray serves 12

$13.99

___Mashed Red Potatoes 4 pound bag

$6.99

___Hash Brown Patties 25 count

$4.99

___Broccoli Frozen 2.5 pound

$3.99

___Corn Frozen 2.5 pound

$3.99

___Green Bean Frozen 2 pound

$3.99

Qty Snacks and Beverages ___Vanilla Yogurt 32 ounce ___Starbucks Ground Coffee (Brews 3 pots) ___Orange Juice 32 ounce ___Uncrustables PB & Grape Jelly each

$2.99 $4.99 $2.99 $0.99

Qty Pantry Items

___Tomato Soup 50 ounce can

$3.99

___Chicken Noodle Soup 50 ounce can $3.99

___Egg Noodles 5 pound

$12.99

___Cereal Raisin Bran 56 ounce bag $10.99

___Cereal Frosted Flakes 40 ounce bag $10.99

Qty Desserts ___Chocolate Cream Pie ___Lemon Meringue Pie ___Sweet Potato Pie

$8.95 $8.95 $11.99

Qty Deli Meat and Cheese ___Roast Turkey Sliced 2 pound ___Roast Beef Sliced 2 pound ___Smoked Ham Sliced 2 pound ___Cheddar Cheese Sliced 1.5 pound ___American Cheese Sliced 5 pound

$8.99 $11.99 $8.99 $5.25 $11.99

To Be Completed by VCS Staff: Pickup Time: _____________ Order Taken by:_____________________________________ Pick-up Date:__________________________________

April 2020

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