Chick-fil-A Request Form

PLEASE NOTE THAT ANY ORDER REQUIRES A MINIMUM OF 48 HOURS ADVANCE NOTICE SO WE CAN ENSURE PRODUCT AVAILABILITY AND QUALITY.

Hours of operation

*SUMMER 2026*

May:
M-F: 11a-1p

June/July:
M-Th: 11a-2p
F: 11a-1p

*FALL 2026*

Monday-Thursday 10am-9pm
Friday 10am-7pm
Saturday 11am-9pm
Sunday CLOSED
*Holiday hours may vary and can be located at www.dineoncampus.com/missouristate

Department/Organization
Address
Budget Number
Requested by
Phone
Approved by
General Information
Pick-up Location - Not available for delivery
Fax number
Email
Event Information
Event Name
Event Location
Number of Attendees
Pickup Date Pickup Date / MM / DD YYYY
Pickup Time Pickup Time : HH MM AM/PM
Business Purpose
Chick-n-Strip Trays

These are for fried Strips ONLY.
Small (serves 8) $52
*Comes with 1-8oz. sauce bottle of choice

Tray of Chick-n-Strips® which are seasoned to perfection, freshly breaded and cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Medium (serves 15) $94.00
*Comes with 2-8oz sauce bottles of choice

Tray of Chick-n-Strips® which are seasoned to perfection, freshly breaded and cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Large (serves 25) $153.50
*Comes with 2-8oz. sauce bottles of choice

Tray of Chick-n-Strips® which are seasoned to perfection, freshly breaded and cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Nugget Trays

These are for fried nuggets ONLY.
Small (serves 8) $52
*Comes with 1-8oz. sauce bottle of choice

Tray of bite-sized pieces of tender chicken breast, freshly breaded, seasoned to perfection and pressure-cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Medium (serves 15) $94.00
*Comes with 2-8oz. sauce bottle of choice

Tray of bite-sized pieces of tender chicken breast, freshly breaded, seasoned to perfection and pressure-cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Large (serves 25) $153.50
*Comes with 2-8oz. sauce bottles of choice

Tray of bite-sized pieces of tender chicken breast, freshly breaded, seasoned to perfection and pressure-cooked in 100% refined peanut oil. Served with your choice of dipping sauce.
Dipping Sauce Options

Individual sauce packets will not be provided. Additional 8oz sauce bottle are available for purchase($3.89)
Signature Chick-fil-A sauce
Garlic & Herb Ranch sauce
Polynesian sauce
Fruit Trays

Enjoy fresh fruit for an extra refreshing treat!
Small (serves 12) $48.50

A great-tasting, nutritious fruit mix made with mandarin orange segments, fresh strawberry slices, blueberries and red and green apple pieces. Prepared fresh at each Restaurant.
Large (serves 26) $96.00

A great-tasting, nutritious fruit mix made with mandarin orange segments, fresh strawberry slices, blueberries and red and green apple pieces. Prepared fresh at each Restaurant.
Dessert Trays

Need something extra sweet for your event? Add a tray of our freshly baked cookies or fudge brownies!
Can't decide?? Get a combo tray!!
Cookie small (12 cookies) $28.50

Baked fresh each day in our Restaurants, these cookies have both semi-sweet dark and milk chocolate chunks, along with wholesome oats for an old-fashioned touch. Small cookie trays contain 12 cookies and large trays contain 24 cookies.
Cookie large (24 cookies) $54.50

Baked fresh each day in our Restaurants, these cookies have both semi-sweet dark and milk chocolate chunks, along with wholesome oats for an old-fashioned touch. Small cookie trays contain 12 cookies and large trays contain 24 cookies.
Brownie small (12 brownies) $18.50

A decadent dessert treat with rich semi-sweet chocolate melted into the batter and fudgy chunks. Small trays contain 12 brownie halves while large trays contain 24 brownie halves.
Brownie large (24 brownies)$36.50

A decadent dessert treat with rich semi-sweet chocolate melted into the batter and fudgy chunks. Small trays contain 12 brownie halves while large trays contain 24 brownie halves.
Combo small (6 cookies & 6 brownies)$22.00

Chocolate Chunk Cookie and Chocolate Fudge Brownie Tray: Baked fresh each day in our Restaurants, our cookies have both semi-sweet dark and milk chocolate chunks, along with wholesome oats for an old-fashioned touch. Our brownies are a decadent dessert treat with rich semi-sweet chocolate melted into the batter and fudgy chunks. Small trays contain (6) cookies and (6) brownie halves while Large trays contain (12) cookies and (12) brownies halves.
Combo large (12 cookies & 12 brownies) $44.00

Chocolate Chunk Cookie and Chocolate Fudge Brownie Tray: Baked fresh each day in our Restaurants, our cookies have both semi-sweet dark and milk chocolate chunks, along with wholesome oats for an old-fashioned touch. Our brownies are a decadent dessert treat with rich semi-sweet chocolate melted into the batter and fudgy chunks. Small trays contain (6) cookies and (6) brownie halves while Large trays contain (12) cookies and (12) brownies halves.
Beverage Information

Please enter the quantity of each beverage - 20 oz. bottles ($3.09), Gallon Tea ($8.50) and Gallon Lemonade ($16.00).
Our Sun-Joy option can be made with sweet/unsweet tea and lemonade or diet lemonade.($13.75)
Dasani Water - 20 oz. $3.09
Sweet Tea - Gallon $8.50
Unsweet Tea - Gallon $8.50
Sun-Joy - Gallon$13.75

(half tea & half lemonade)
Lemonade - Gallon $16
Diet Lemonade - Gallon $16
Complimentary Items.

Complimentary Items. Plates Forks Napkins

Please provide # of attendees
Payment Information
Method of Payment

Method of Payment Cash/Check Credit/Debit Card Department Charge

*Dept. Charges are budget #'s ONLY
*Checks make payable to Chartwell's

*If you are tax exempt, please provide the appropriate documentation with the submission of this form.
Order Requested By
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Full Name

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Chick-fil-A Request Form

Chick-fil-A Request Form

General Information

Event Information

Chick-n-Strip Trays

Nugget Trays

Dipping Sauce Options

Fruit Trays

Dessert Trays

Beverage Information

Payment Information