Organization: ______________________________________

Organization: ______________________________________
President: _________________________________________
President: _________________________________________
Advisor: ___________________________________________
Advisor: ___________________________________________
Name of Student: ____________________________________
Name of Student: ____________________________________
Name of Dish: ______________________________________
Name of Dish: ______________________________________
Type of Dish (please check off):
Type of Dish (please check off):
___ Vegetarian ___ Pork ___ Fish
___ Vegetarian ___ Pork ___ Fish

___ Chicken ___ Beef Other: ______________

___ Chicken ___ Beef Other: ______________
Food Must Be Kept (please check off):
Food Must Be Kept (please check off):
___ Refrigerated
___ Refrigerated
___ Room Temperature
___ Room Temperature
___ Heated Up
___ Heated Up
Specific Instructions Regarding Dish: (i.e. Heat at 400° for 10
minutes) Specific Instructions Regarding Dish: (i.e. Heat at 400° for 10
minutes)

Organization: ______________________________________ Organization: ______________________________________

President: _________________________________________ President: _________________________________________

Advisor: ___________________________________________ Advisor: ___________________________________________

Name of Student: ____________________________________ Name of Student: ____________________________________

Name of Dish: ______________________________________ Name of Dish: ______________________________________

Type of Dish (please check off): Type of Dish (please check off):

___ Vegetarian ___ Pork ___ Fish ___ Vegetarian ___ Pork ___ Fish

___ Chicken ___ Beef Other: ______________ ___ Chicken ___ Beef Other: ______________

Food Must Be Kept (please check off): Food Must Be Kept (please check off):

___ Refrigerated ___ Refrigerated

___ Room Temperature ___ Room Temperature

___ Heated Up ___ Heated Up

Specific Instructions Regarding Dish: (i.e. Heat at 400° for 10 Specific Instructions Regarding Dish: (i.e. Heat at 400° for 10
minutes) minutes)