Meal Service Sign Up

Let’s Dish Meal Service Client Information

My name is Sue Cotch and I am the chef and owner of Let’s Dish! Personal Chefs.I have put together a service, which provides meals that are low in calories, carbohydrates and fat but high in taste and fun These meals are packaged for microwave oven use and include heating instructions as well as carb, calorie, protein, fiber and fat information. The menus include three daily meals, are available in five-day and seven-day plans and will be delivered to your home or workplace every Tuesday and Friday. Please complete the required information below so that I can set you up and begin helping you work toward your weight-loss goals.Good luck!

email address: Leave this field email-address blank:
Homepage: Leave this field homepage blank:
URL: Leave this field url blank:
Comment: Leave this field comment blank:

Name*:
Address*:
Delivery Instructions (We can deliver to your home or workplace and can leave food in a cooler if necessary. Also, we can keep a set of keys and place your meals in your refrigerator.): *:
Phone #:
Cell #:
Confirm Email Address*:
Select Service*:	3 Day5 Day
Select Calorie Plan*:	1,2001,800
Which Health Club, If Any, Do You Belong To?:
What foods are your allergic to/can’t eat/dislike? :
Are you interested in purchasing meals for other members of your family?:	YesNo
If so, how many members would you need meals for and what are their names?:
Roughly, how much do you spend on groceries per week? :
What weight loss food programs have you done in the past, if any (i.e., Seattle Sutton, Weight Watchers Frozen Entrees, Lean Cuisine)? Did you like them? What didn’t you like about them? :
How did you hear about Let’s Dish (friend, workout facility, website, etc.)? :
Preferred Method of Payment:*:	CheckCredit Card (Visa or Mastercard)
Verification:	13 subtract 8 =  Fill in the result