EzDineInn Inc.
2000 San Pablo Avenue
Berkeley, CA 94704
(510) 644-3331 (W)
(510) 644-3334 (F)
http://www.ezdineinn.com/
Email:
inquiry@ezdineinn.com
Please print multiple copies of this form to place your order by fax
Restaurant Name :
Customer Name :
Address :
City, State, Zip :
Order Date/Time :
Customer's Contact Phone# :
Item#
Food description with preference (include drinks also)
Quantity
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(925) 551-7778