Pizza Order Form

Select Pizza Size

Small - $8
Medium - $12
Large - $15
Extra Large - $18

Select Toppings ($1 each)

Pepperoni - $1
Mushrooms - $1
Onions - $1
Sausage - $1
Bacon - $1
Extra Cheese - $1
Black Olives - $1
Green Peppers - $1

Select Sides

Garlic Bread - $5
Wings (10 pcs) - $8
Cheese Sticks - $6

Select Drinks

Coke - $2
Diet Coke - $2
Sprite - $2
Water - $1

Your Information

Name:

Phone Number:

Email: