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Soul Food Takeout Order Form
Pickup
Date & Time of Pickup* 
Order No*
Breakfast
Breakfast
Egg Specialty Breakfast 3 egg prepared to order and your choiceof bacon or sausage with hash browns rice or grits. Served with toast.
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Breakfast
Ham Egg Specialty Breakfast 3 egg prepared to order and served with ham (off the bone) with hash browns rice or grits. Served with toast.
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Breakfast
Turkey Egg Specialty Breakfast 3 egg prepared to order and turkey sausage or bacon with hash browns, rice or grits.
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Breakfast
Cheese Omelette Breakfast Served with hash browns, rice or grits toast.
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Breakfast
Ham Omlette Breakfast Served with hash browns, rice or grits and toast.
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Breakfast
Denver Omlette Breakfast Served with hash browns, rice or gritsand toast.
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Breakfast
Western Omlette Breakfast Served with hash browns, rice or grits and toast.
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Breakfast
Turkey Bacon Omlette Breakfast Served with hash browns, rice orgrits and toast.
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Breakfast
Turkey Sausage Omlette Breakfast Served with hash browns, rice or grits and toast.
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Breakfast
Short Stack Breakfast With bacon or sausage.
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Breakfast
Short Stack With turkey bacon or sausage.
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Breakfast
Tall Stack Breakfast
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Breakfast
Tall Stack Breakfast With turkey bacon or sausage.
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Breakfast
French Toast Breakfast Served with 2 eggs and bacon, sausage, turkey bacon or turkey sausage.
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Breakfast
Salmon Croquettes Breakfast Served with hash browns, rice or grits and toast.
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Breakfast
Breakfast Sandwich Breakfast Ham or sausage with eggs.
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Breakfast
Sausage and Egg Biscuits Breakfast
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Breakfast
Sausage Biscuits Breakfast
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Breakfast
Turkey Breakfast Sandwich Breakfast Turkey with eggs.
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Breakfast
Bowl of Oatmeal Breakfast
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Breakfast
Small French Toast Breakfast Served with tow eggs and bacon, sausage, turkey bacon or turkey sausage.
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Breakfast Sides
Breakfast Sides
Ham off the Bone Breakfast
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Breakfast Sides
4 Slice Bacon Breakfast
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Breakfast Sides
Turkey Sausage Breakfast
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Breakfast Sides
Sausage Patties Breakfast
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Breakfast Sides
Smoked Sausage Breakfast
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Breakfast Sides
Salmon Croquettes Breakfast
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Breakfast Sides
Grits Breakfast
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Breakfast Sides
Rice Breakfast
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Breakfast Sides
Country Fried Potatoes Breakfast
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Breakfast Sides
2 Slice Toast Breakfast
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Breakfast Sides
2 Biscuit Breakfast
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Breakfast Sides
2 Egg Breakfast
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Breakfast Sides
Slice of Cheese Breakfast
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Breakfast Sides
Bell Pepper and Onions Breakfast
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Specials
Specials
6 Dollar Holla Special
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Specials
Pork Chop Sandwich Special
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Specials
Steak Sandwich Special
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Specials
Catfish Sandwich Special
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Specials
Mini Rib Tips Special
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Specials
Large Rib Tips Special
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Specials
Chicken and Waffles Special Served with 1 side.
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Specials
Salmon Croquettes Special Served with 2 sides.
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Dinner
Dinner
Beef Short Ribs Dinner
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Dinner
6 Dollar Holla Dinner
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Dinner
Smothered Chops Dinner
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Dinner
Catifsh Dinner
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Dinner
Turkey Wings Dinner
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Dinner
Smothered Steak Dinner
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Dinner
Roast Beef Dinner
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Dinner
Pot Roast Dinner
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Dinner
Rib Tips Dinner
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Dinner
Corned Beef Dinner
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Dinner
Baked Chicken Dinner
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Dinner
Smothered Chicken Dinner
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Dinner
Fried Chicken Dinner
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Dinner
BBQ Chicken Dinner
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Dinner
Meat Loaf Dinner
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Dinner
Vegetable Plate Dinner
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Dinner
BLT Sandwich Dinner
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Dinner Sides
Dinner Sides
Corn Bread Dressing
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Dinner Sides
Macroni and Cheese
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Dinner Sides
Red Beans and Rice
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Dinner Sides
Mashed Potatoes
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Dinner Sides
Black-eyed Peas
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Dinner Sides
Lima Beans
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Dinner Sides
Potato Salad
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Dinner Sides
String Beans
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Dinner Sides
Spaghetti
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Dinner Sides
Coleslaw
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Dinner Sides
Cabbag
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Dinner Sides
Greens
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Dinner Sides
Rice
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Dinner Sides
Corn
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Dinner Sides
Candied Yams
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Beverages
Beverages
Iced Tea
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Beverages
Lemonade
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Beverages
Coffee
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Beverages
Pop
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Beverages
Orange Juice
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Beverages
Iced Water
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Beverages
Apple Juice
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Dessert
Dessert
Peach Cobbler
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Dessert
Better than Cake
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Dessert
Gourmet Carrot Cake
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Dessert
Supreme Cheescake
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Dessert
Banana Pudding
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Dessert
Bread Pudding
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Dessert
Sweet Potato Pie
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Dessert
Scoop of Ice Cream
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Billing Information
First Name:*Same name as on your card
Middle Initial:
Last Name:*
Address Line 1:*Where your statement is mailed
Address Line 2:Apt. or Suite No.
City:*
State:*
Zip Code:*
Phone:
Payment Information
Payment Method:*
Credit Card PayPal 
Card Number:*No dashes or spaces please
Expiration Month:*From your card
Expiration Year:*From your card
Card Brand:*
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