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Fish Fry Order Form

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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  This order is for which day? (please select one) REQUIRED Friday, March 28th Friday, April 4th Friday, April 11th Please fill out this field.
  
  Please select one REQUIRED Dine-In Take Out Please fill out this field.
  
  Fried Catfish Dinner12.0
  
  How many Fried Catfish Dinners would you like? Please enter an integer (number).
  
  Fried Shrimp Dinner12.0
  
  How many Fried Shrimp Dinners would you like? Please enter an integer (number).
  
  Fried Combo Dinner12.0
  
  How many Combo Dinners would you like? Please enter an integer (number).
  
  Baked Catfish Dinner12.0
  
  How many Baked Catfish Dinners would you like? Please enter an integer (number).
  
  Kid's Fried Catfish Dinner6.0
  
  How many Kid's Fried Dinners would you like? Please enter an integer (number).
  
  Kid's Shrimp Dinner6.0
  
  How many Kid's Shrimp Dinners would you like? Please enter an integer (number).
  
  Kid's Baked Catfish Dinner6.0
  
  How many Kid's Baked Dinners would you like? Please enter an integer (number).
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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St. Mary Magdalene

Flint, Texas

Fish Fry Order Form