To order pizza for take-out from Taira's Pizzaria please fill out the form below.

Select Ms. Mrs. Mr. First Name: Last Name:

Phone number: Address: (if delivery)

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Pizza

Delivery Take- Out

Pizza Size: Select Small Medium Large Small- $7.00 Medium-$9.00 Large-$11.00

Number of pizzas:

Toppings: Cheese Pepperoni Sausage

Peppers Mushrooms Olives Ham

Crust: Pan Deep Dish Stuffed Thin

Payment

Cash Credit Card Personal Check

Credit Card #: Expiration Date: / Security Code:

Name (as written on Credit Card):

Billing Address:

City: State: Select AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NC NJ NM NY ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY Zip Code:

Taira's Pizzaria - 4455 Atlantic Blvd - Jacksonville, FL 32207 - Phone #: 904 396-5751 - Fax #: 904 396-7209