Name *

First Name

Last Name

Phone *

(###)

###

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How much soup & extras? *

Check all that apply. Please indicate total qty chips & salsa in Notes. Thanks

Taco Soup for Uno (serves 1) $5.00

Taco Soup for Dos (serves 2) $10.00

Taco Soup for The Familia (serves 6) $30.00

Corn Chips (serves 1) $1.00

Salsa (serves 1) $1.00

Soup for ..... (indicate number of bowls in note section)

Drink (bottled water, Dr Pepper, Sprite, or Coke)$2.00