EzDineInn®
inquiry@ezdineinn.com
Phone : (510) 644-3331
Fax : (510) 644-3334
 
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