Chipotle Menu Order Form
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1DATE
COMPANY NAME
CONTACT NAME
PHONE
PICK-UP TIME?
PAGE
OF
1
START HERE
(PLEASE PRINT)
2
Complete the form below.
BURRITOS, TACOS & SALADS
BURRITOS & BOWLS
+
$
1.80
WITH
ORDER
cilantro-lime rice, vegetarian black beans or
RICE
BEANS
SALSA
DAIRY
N/c oN
DRINK
cIRcLE oNE
FAJITA
VEG ITEMS
burrito • burrito boWL
pinto beans (cooked with bacon), meat, salsa,
NAME
PLEaSE WritE iN FLaVor
VEG
cRISPy TAcoS • SofT fLoUR TAcoS
MiLd
MEd
MEd
aNd SPECiFY SiZE
and cheese or sour cream. Served in a flour
WHitE broWN BLAcK PINTo
CHk
cAR
STEAK
BAR
VEG
Hot
SoUR cR CHEESE GUAcAMoLE LETTUcE
SoFt CorN taCoS • SaLad
ToM
coRN
GREEN
tortilla or in a bowl.
TACOS
1
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
Three crispy corn, soft corn or soft flour tortillas
with meat, salsa, sour cream or cheese, and lettuce.
SALADS
2
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
chopped romaine lettuce with choice of beans,
meat, salsa and cheese. Served with freshly
made chipotle-honey vinaigrette.
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
3
CHICKEN
$
6.25
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Marinated in our chipotle
4
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
adobo, then grilled.
STEAK
6.65
$
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Marinated in our chipotle
5
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
adobo, then grilled.
CARNITAS
6.65
$
. . . . . . . . . . . . . . . . . . . . . . . . . .
Seared pork, braised for
6
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
hours, then shredded.
BARBACOA
$
6.65
. . . . . . . . . . . . . . . . . . . . . . . .
Beef braised for
7
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
hours, then shredded.
VEGETARIAN
6.25
$
. . . . . . . . . . . . . . . . . . . . . .
A vegetarian option with our freshly made
8
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
guacamole and vegetarian black beans.
SALSAS
9
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
Fresh Tomato . . . . . . . . . . . . . . . . . . . . . . . . Mild
Roasted Chili-Corn . . . . . . . . . . . . . . . Medium
Tomatillo-Green Chili . . . . . . . . . Medium Hot
Tomatillo-Red Chili . . . . . . . . . . . . . . . . . . . Hot
10
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
EXTRAS
Chips & Guacamole
2.95
$
. . . . . . . . . . . . . . . . . . . . . .
11
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
Chips & Salsa
1.75
$
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Guacamole
1.80
$
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Chips
$
1.25
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
DRINKS
Bottled Drinks
2.10 /
2.50
$
$
. . . . . . . . . . . . . . . . . .
Example
Burrito
Lg Coke
Soda
1.60 /
1.90
$
$
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
W BR B
P
F
C CA S
B
V
M MC MG H SC
C
G
L
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