Name *

First Name

Last Name

Phone *

(###)

###

####

Preferred Method of Contact

How would you like us to reach you?

Phone

Email

Either (No prefence)

Date of Event *

What is the Date of your Event?

MM

DD

YYYY

Time of Event *

What Time Does Your Event Start?

Hour

Minute

Second

AM PM

Will you require your order to be Delivered or Picked-Up at Stone House Grille (Kimberton)

Select Option

Delivery (Please provide address below)

Pick-Up (Pick Up at Stone House Grille 1300 Hares Hill Rd Kimberton

Requested Delivery/Pick-Up Date *

What Date Would You Like to Have you Catering Order Delivered/Picked Up?

MM

DD

YYYY

Time of Delivery/Pick-Up

What Time Would you Like to Have your Catering Order Delivered/Picked-Up?

Hour

Minute

Second

AM PM

If Requesting Delivery of Catering, Please Provide Delivery Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Types of Food for Event *

Select the types of food you would be interested in having us prepare for you. (Select all that apply)

Soup

Salads

Burgers

Wraps

Pasta

Desserts

Vegetarian Options

Gluten Free Options

Fish Entree

Beef Entree

Chicken Entree

Vegetable Side

Starch Side

Beverages (Cold)

Allergy Information *

Please let us know of any food allergies.

None that I am aware of

Celiac Disease

Dairy Allergy

Nut Allergy

Soy Allergy

Garlic Allergy