* Required fields First Name:* Last Name:* Email:* Address:* -- Please Select -- 1-3 4-6 Haven't How many times per month do you dine with us?* -- Please Select -- Online Take-out Third Party Delivery How do you order?* Any dietary needs?* -- Please Select -- Seafood Pork Beef Shellfish Poultry Which protein do you prefer?* Which vegetable do you NOT prefer?* Which spice do you NOT prefer?* Any dietary needs?* -- Please Select -- Chocolate Non-chocolate Do you prefer chocolate or non-chocolate desserts?* -- Please Select -- Yes No Do you enjoy a cocktail at dinner?* -- Please Select -- White Red Rose Sparkling Wine preference?* Beer choices?* Thank you for your support in 2021! Eddie Bernal and 34th Street Cafe & Santa Rita Teams!!