2017 MTD order (PDF)
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Author: Dairy Queen
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DQ Grill & Chill Belle Fourche
Treat yourself and/or your staff to a delicious Blizzard and help the smallest patients in our area.
Miracle Treat Day is taking place Thursday, July 27th at the DQ Grill & Chill. Please take the time to have
your staff sign up for their Blizzard Treat and return this form (drop off/fax/email)anytime on or before
Thursday, July 27th and we will have your order ready for you.
Mini (8oz.) $3.11 Small (12oz.) $3.64 Medium (16oz.) $3.97 Large (21oz.) $4.50
Extra Toppings and Royal Blizzards available for additional charge.
For an up-to date list of Blizzard Flavors, please visit www.dairyqueen.com
Business Name:____________________________________
Contact Person:_____________________ Telephone Number:_____________
Name
Size
Flavor (Oreo, Cookie Dough, PB Cup, Heath,
Butterfinger, Chocolate Xtreme, etc)
Flavors: Oreo, Reeses, M&M, Butterfinger, Heath, Cookie Dough, Salted Caramel
Truffle, Turtle Pecan Cluster, Banana Split, Chocolate Extreme. Many of our
flavors are seasonal, so we will make the best accommodations we can.
Pick-up Time:_____________
Email: dairyqueen3@rushmore.com
Phone : 723-7222Fax:723-7224
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