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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