Panda Express Request Form

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

Hours of Operation

Monday-Friday
10am-7pm

Saturday
11am-7pm

SUMMER HOURS - beginning June 3rd, 2025
Monday-Thursday 11am-2pm

*Holiday hours may vary and can be located at www.dineoncampus.com/missouristate

Pick-up Location - can not be delivered
Phone
General Information
Approved by
Requested by
Fax number
Email
Event Information
Department/Organization
Event Name
Event Location
Address
Number of Attendees
Budget Number
Pickup/Delivery Date Pickup/Delivery Date / MM / DD YYYY
Pickup/Delivery Time Pickup/Delivery Time : HH MM AM/PM
Business Purpose
Party Information

Small Parties include 2 entrees and 2 sides
Medium Parties include 3 entrees and 3 sides
Large Parties include 4 entrees and 4 sides

*All trays come with complimentary fortune cookies

**Premium Upcharge: $15/ tray
Small Party Tray (serves 12-16) $119

2 Party Tray Entrees, 2 Party Tray Sides, Fortune Cookies
Medium Party Tray (serves 18-22) $168

3 Party Tray Entrees, 3 Party Tray Sides, Fortune Cookies
Large Party Tray (serves 26-30) $211

4 Party Tray Entrees, 4 Party Tray Sides, Fortune Cookies
Entrees

Please provide the amount of of each item for the tray selected above.
Orange Chicken
String Bean Chicken Breast
Cashew Chicken
Broccoli Beef
Sweet Fire Chicken Breast
Beijing Beef
Mushroom Chicken
Kung Pao Chicken
Veggie Spring Rolls (48)
Chicken Egg Rolls (24)
Black Pepper Angus Steak**

**Premium Item additional $15 upcharge
Honey Walnut Shrimp**

**Premium Item additional $15 upcharge
Sides

Please provide the amount of each item for the tray selected above.
Mixed Veggies
Chow Mein
Fried Rice
Steamed Rice
A La Carte Items

Please be advised, any 1 order of an A la carte item, entree or side, will serve 12-16 people.
A La Carte Party Tray Entree (serves 12-16) $45

12-14 Servings Per Party Tray
Orange Chicken
String Bean Chicken Breast
Cashew Chicken
Broccoli Beef
Sweet Fire Chicken Breast
Beijing Beef
Mushroom Chicken
Kung Pao Chicken
Veggie Spring Rolls (48)
Chicken Egg Rolls (24)
Honey Walnut Shrimp**

**Premium Item additional $15 upcharge
Black Pepper Angus Steak**

**Premium Item additional $15 upcharge
A La Carte Party Tray Side (serves 8-10) $22

10-12 Servings Per Party Tray
Mixed Veggies
Chow Mein
Fried Rice
Steamed Rice
Complimentary Items

Complimentary Items Plates Napkins Forks Chopsticks

Please provide # of attendees
Beverage Information

Please enter the quantity of each beverage - 20 oz. bottles (Prices vary).
Coca Cola - 20 oz.

$2.39
Dr. Pepper - 20 oz.

$2.39
Powerade- 20 oz.

$2.39
Dasani - 20 oz.

$2.19
Payment Information
Method of Payment

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

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

*If you are tax exempt, please provide the appropriate documentation with the submission of this form.
Order Requested By
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Panda Express Request Form

Panda Express Request Form

General Information

Event Information

Party Information Small Parties include 2 entrees and 2 sides Medium Parties include 3 entrees and 3 sides Large Parties include 4 entrees and 4 sides *All trays come with complimentary fortune cookies **Premium Upcharge: $15/ tray

Entrees

Sides

A La Carte Items

Beverage Information

Payment Information

Party Information

Small Parties include 2 entrees and 2 sides
Medium Parties include 3 entrees and 3 sides
Large Parties include 4 entrees and 4 sides

*All trays come with complimentary fortune cookies

**Premium Upcharge: $15/ tray