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Name: form65fb7ed90ed29 — POST

<form class="fl-insite-form" id="form65fb7ed90ed29" name="form65fb7ed90ed29" data-node="65fb7ed90ed29" method="post" onsubmit="return false;" target="hiddenIframe65fb7ed90ed29" enctype="multipart/form-data">
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              <label class="form-divider"> We'd like your opinion on the following (this is just a poll)... </label>
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              <div class="divider">&nbsp;</div>
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            <div class="form-label" style="display:inline-block">
              <label class="form-radio"> Would you be interested in dessert? <span style="color:red">*</span>
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      <br>
      <div class="form-field" style="margin-left:5px;text-align:left;display:none;">
        <div class="profitDialCheckboxText"> You agree to receive automated messages. Expect up to 4/msgs/month. No purchase is required. To Unsubscribe, reply STOP. Need Assistance? Reply HELP. Standard Msg&amp;Data Rates may apply. See our terms
          &amp; privacy policy below. </div>
        <input type="checkbox" name="optin_check_516666" id="optin_check_516666">
        <label for="optin_check_516666"> I agree to terms </label>
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        font-weight: 700;
        padding:10px;
        border: 0;
        border-radius:0px;
        background-color:#1e73be;
        color:#fff;
        width:100%;"> Place Order &gt;&gt; <span id="loading-img" style="display:none;"><img src="/public/images/loading.gif" alt="loading"></span>
        </button></center>
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</form>

Text Content

Please make your dinner selections for our family gathering using the form on
this page.


 * Name *
   
 * Email *
   
 * What would you like to order? *
   Chicken Alfredo
   Chicken and Shrimp Carbonara
   Chicken Parmigiana
   Tour of Italy
   Shrimp Alfredo
   Chicken Marsala Fettuccine
   Ravioli Carbonara
   Lasagne Classico
   Spaghetti and Meatballs
   Spaghetti with Meat Sauce
   Spaghetti with Marinara
   Fettuccine Alfredo
   Chicken Tortelloni Alfredo
   Shrimp Scampi
   Seafood Alfredo
   Five Cheese Ziti al Forno
   Cheese Ravioli
   Chicken Scampi
   Eggplant Parmigiana
   Grilled Chicken Margherita
   Herb-Grilled Salmon
   6 oz. Sirloin
   
 * Each entree comes with 2 breadsticks and choice of... *
   Famous House Salad (Dressing on the side)
   Pasta e Fagioli Soup
   Zuppa Toscana Soup
   Chicken & Gnocchi Soup
   Minestrone Soup
   I don't want salad or soup
   
 * Would you be interested in coffee? *
   Yes - Regular
   Yes - Decaf
   No coffee for me
   
 * We'd like your opinion on the following (this is just a poll)...
    
 * Would you be interested in dessert? *
   Sicilian Cheesecake
   Tiramisu
   Black Tie Mousse Cake
   ANY of the above
   No dessert for me
   



You agree to receive automated messages. Expect up to 4/msgs/month. No purchase
is required. To Unsubscribe, reply STOP. Need Assistance? Reply HELP. Standard
Msg&Data Rates may apply. See our terms & privacy policy below.
I agree to terms
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