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Elements Sandwich Order Form:)
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Name For Order
*
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Select your bread
French l 197 Cal.
Sourdough l 350 Cal.
Sliced White l 200 Cal.
Bolillo l 150 Cal.
Wheat l 300 Cal.
Lettuce Wrap l 10 Cal.
Other:
Select Your Meat
Oven Roasted Turkey l 140 Cal.
Ham l 100 Cal.
Rotisserie Chicken Salad l 310 Cal.
Tuna Salad l 250 Cal.
Italian Blend l 280 Cal.
Roast Beef l 120 Cal.
Bacon - $1 l 70 Cal.
Double Meat - $3
Other:
Select Your Cheese
Havarti l 120 Cal.
Cheddar l 110 Cal.
Pepper Jack l 100 Cal.
Horseradish Cheddar l 100 Cal.
Provolone l 100 Cal.
Swiss l 120 Cal.
American l 110 Cal.
Gouda l 100 Cal.
Other:
Select Your Veggies
Shredded Lettuce l 5 Cal.
Sliced Tomatoes l 5 Cal.
Pepperoncini l 10 Cal.
Pickles l 5 Cal.
Sliced Red Onions l 6 Cal.
Black Olives l 25 Cal.
Sliced Cucumbers l 4 Cal.
Avocado -$1 l 48 Cal.
Other:
Select Your Dressing
Mayo l 90 Cal.
Yellow Mustard l 6 Cal.
Dijon Mustard l 10 Cal.
Horseradish l 13 Cal.
Honey Mustard l 60 Cal.
Classic Italian l 82 Cal.
Other:
Special Request
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Food Allergies
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