Name *

First Name

Last Name

Phone *

(###)

###

####

Pick Up Date, requested *

Monday-Saturday only

MM

DD

YYYY

Pick Up Time, requested *

Not available for pick up during brunch

Hour

Minute

Second

AM PM

I'd like to add the following to my order. *

Gumbo

Queso & Chips

Guac & Chips

Shrimp "Boil"

Fried Chicken Salad

Wedge Salad

Caesar Salad

Jambalaya

Red Beans & Rice

Shrimp & Grits

Smoked Wings

Hot Chicken

Banana Pudding

I need plastic utensils *

Yes

No

I understand that this is a *request* and submission does not confirm my order. A member of the 55 South team will email me an official order form and contract to sign. I understand that executed document is the only way to confirm my order. The restaurant will be in touch with me about my request within 24h from submitting, Mon-Fri.

Yes, I understand the above.