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
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

Address
Phone
General Information
Pick-up Location - Not available for delivery
Email
Budget Number
Approved by
Department/Organization
Requested by
Fax number
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) $48
*Comes with 1-8oz. sauce bottle of choice
Medium (serves 15) $84.50
*Comes with 2-8oz sauce bottles of choice
Large (serves 25) $139
*Comes with 2-8oz. sauce bottles of choice
Nugget Trays

These are for fried nuggets ONLY.
Small (serves 8) $48
*Comes with 1-8oz. sauce bottle of choice
Medium (serves 15) $84.50
*Comes with 2-8oz. sauce bottle of choice
Large (serves 25) $139
*Comes with 2-8oz. sauce bottles of choice
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) $45.50
Large (serves 26) $88.50
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) $26
Cookie large (24 cookies) $48
Brownie small (12 brownies) $17.50
Brownie large (24 brownies)$35
Combo small (6 cookies & 6 brownies)$21.50
Combo large (12 cookies & 12 brownies) $43
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