You are on page 1of 1

Palengke Express Order Form

www.PalengkeExpress888.com
LIVE HELP: (626) 757‐6395 or (818) 919‐4485  (8:30AM‐ 6PM)   FAX#: (323) 417‐5168  (24 hours)
Name: ________________________
Address: _________________________________________________________________ 
Telephone#: ________________________ Cellphone#: __________________
Fax#: __________________________ Email Address: __________________
Date Ordered: ____________________ Time of Deliver (example: 12‐3pm)
Date of Delivery: __________________
Terms or Payment:Cash or Credit Card#:______________________   Expiration Date:_____

Quantity Description of Items Unit Price Sub Total


lbs/bundle Specify Cut: Meat/Fish/Chicken
    or pcs

Total:
Legend:
      Choices for Meat Cut                  Fish
Spareribs & Neckbone:                Cleaning
                 Sinigang Cut                Scalling
Porkbutt:Thin Slice                Cut in half
Beef Shank: Bulalo Cut                Cut into 4 or 5
Short Ribs: Korean BBQ
                 or Sinigang Cut

Order Received by:_______________________

You might also like