HELLO! CAN YOU HELP OUR RESTURAUNT? TAKE THIS SURVEY!!

Please take this short survey to help us understand what people in the community would like see come to their community in our resturaunt!

ABOUT YOU!

Name  
Phone 		DOB  Gender Male
            Female
Address Internet Experience
 Email Address
  
City State ZIP
Date Today
Survey...      
Do you like to eat out? Strongly Agree Agree   Disagree
Do you eat vegetables every day? Strongly Agree Agree Disagree
Do you prefer chicken over red meat? Strongly Agree Agree Disagree
Do you eat fruit every day? Strongly Agree Agree Disagree
Do you eat out at least once a week? Strongly Agree Agree Disagree
Do you normally order an appetizer when you go out to eat? Strongly Agree Agree Disagree
Do you normally order dessert? Strongly Agree Agree Disagree
Usually are there 2 or more persons dining with you? Strongly Agree Agree Disagree
Do you order alcoholic beverages? Strongly Agree Agree Disagree
Do you prefer fast friendly service? Strongly Agree Agree Disagree
RESULTS!!      
Want Summary results?       Yes     No
Comments:
Email Address    

Thank you so much for taking the time to fill this survey out! It really means alot to us!