60-66 Queen Street, Busselton WA 6280 08 9751 2399 info@samovar.com.au www.samovar.com.

au

TAKEAWAY ORDER FORM

Name: mobile:

Date: Pick Up /Delivery Time:

! Pick Up

! Delivery (CBD only) Address:

eMail to info@samovar.com.au or FAX to 9751 2433 by 10:30 am same day.

ITEM Salads Salad Bowl Small Salad Bowl Large Choose from ! Greek Salad Caesar Salad Wraps ! Garden Salad ! Potato Salad PRICE $ 5.00 $ 8.50 ! Quinoa, Feta, Pumpkin & Spinach $ 15.00 $ 7.00 $ 8.50 $ 8.50 $ 8.50 QTY SUBTOTAL

Cri sp cos, bacon, croutons and parmesan roasted garlic aioli Seasonal vegetables, feta, mesclun leaves, sweet chilli mayo

Roast Vegetable Virginia Ham Roast Beef

with honey mustard dressing, mesclun leaves, cheddar cheese with mesclun, aioli, carrot, cucumber, capsicum, red onion

Garlic & Herb Chicken

with caramelised onion, cheddar cheese, hot english mustard & mesclun

Sandwiches

! Multigrain Bread

! White Bread

! Gluten Free Bread +$1.50 $ 6.00 $ 7.00

Salad mesclun leaves, tomato, carrot, capsicum, cucumber, red onion Choose from ! Virginia Ham ! Chicken ! Roast Beef
All served with salad

Toasted Sandwiches ! Multigrain Bread Cheese & Chutney

! White Bread

! Gluten Free Bread +$1.50 $ 6.50 $ 7.00 $ 7.00 $ 8.50 $ 8.50 $ 8.50 $ 9.00 $ 10.50

Virginian Ham and Cheese Chicken, Cheese and Mayonnaise Toasted Foccacia Roasted Vegetables with feta and Samovar's own pesto Roast Beef Chicken Chef's Choice
with onion, cheese & hot english mustard

with bacon, cheese and rocket leaves

Pizza Ham & Cheese Savoury Tart of the Day Lasagne Quiche ! Meat ! Vegetable ! Lorraine ! Vegetarian

$ 11.00 $ 11.00 $ 4.50 $ 16.00 $ 24.00

Gourmet Cupcake

Vanilla or Chocolate iced cupcakes with 3 decorating treats

Box of Four (4) Gourmet Cupcakes ! Vanilla ! Chocolate ! Mixed Box of Six (6) Gourmet Cupcakes ! Vanilla ! Chocolate ! Mixed

PTO for Takeaway Drinks Total

SAM45 MAR 14

Paying by:

! CASH

! VISA/MASTERCARD

! EFTPOS

TOTAL

Coffee

Tea

Cupcakes

Kids Zone

Community

Fit&Fab

Fun

Friendly

Family Feast

60-66 Queen Street, Busselton WA 6280 08 9751 2399 info@samovar.com.au www.samovar.com.au

Coffee

ITEM Flat White Cappuccino Long Black Latte Chai Latte Short Macchiato Long Macchiato Mocha Hot Chocolate ! Extra Shot of Coffee +0.80c ! one sugar ! two sugars ! Full Cream Milk ! Skinny Milk ! Soy Milk ! Lactose Free Milk

PRICE QTY $ 4.50 $ 4.50 $ 4.50 $ 4.50 $ 4.50 $ 4.00 $ 4.00 $ 5.00 $ 5.00 $ 0.80 $ 0.50

SUBTOTAL

Tea

! English Breakfast ! Earl Grey ! Peppermint ! Chamomile ! Sencha $ 4.50 ! one sugar ! two sugars ! Full Cream Milk ! Skinny Milk ! Soy Milk ! Lactose Free Milk $ 0.50 Forever Young anti~ageing blueberries, mango, strawberries & coconut water Green Power Gulp kale, apple, green grapes & cucumber Energy Upper lychees, peaches & coconut water Georgie Girl apple, orange & carrot Extra ! Spirulina ! Chia ! Goji +2.50.ea Cherry Ripe spinach, coconut milk , cherries , banana, cocoa, cinnamon Chia Green almond, chia seed, spinach, banana, coconut milk, honey & cinnamon Tropical Twist mango, banana, coconut milk, natural yoghurt, & tropical juice blend All Natural Banana Smoothie Real Fruit Smoothie Iced Coffee with the works (icecream and topped with cream) Iced Chocolate with the works (icecream and topped with cream) ! Chocolate ! Vanilla ! Strawberry ! Spearmint ! Banana ! Caramel Extra Malt Extra icecream
All with icecream

Jumpin' Juices Cold Pressed Daily

$ $ $ $ $

7.50 7.50 7.50 7.50 2.50

Samo's Super Smoothies

$ 7.50 $ 7.50 $ 6.50 $ $ $ $ $ $ $ $ 6.50 6.50 6.50 6.50 6.50 6.50 0.50 1.50

Samo Specialties

Milkshakes

Juices ! Apple 450ml ! Orange 450ml Quenchers 250ml ! Orange ! Orange & Mango ! Orange & Passionfruit Soft Drinks ! Coke 600ml ! Diet Coke 600ml ! Coke Zero 600ml ! Sprite 600ml ! Lift 600ml ! Fanta 600ml

$ 4.50 $ 3.00 $ 4.50 $ 4.50 Drinks Subtotal

Coffee

Tea

Cupcakes

Kids Zone

Community

Fit&Fab

Fun

Friendly

Family Feast