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Customer Name: Surname
---------------------------------: First name
Address:
Home / Mobile Telephone No.:
Fax Number:
Occupation:
Date of Birth:
E-mail Address:
What attracted you to our establishment?	FOOD
	VALUE FOR MONEY
	ATMOSPHERE
How did you hear about us?	PRESS
	RECOMMENDATION
	PASSING BY
How did we do?
SERVICE	BAD AVERAGE GOOD EXCELLENT
QUALITY OF FOOD	BAD AVERAGE GOOD EXCELLENT
VALUE FOR MONEY	BAD AVERAGE GOOD EXCELLENT
ATMOSPHERE	BAD AVERAGE GOOD EXCELLENT
INTERIOR	BAD AVERAGE GOOD EXCELLENT
STAFF ATTENTIVENESS	BAD AVERAGE GOOD EXCELLENT
How often do you visit us?	OCCASIONALLY OFTEN FREQUENTLY LUNCH EVENING
How likely are you to visit again?
NOT LIKELY
LIKELY
VERY LIKELY
Any Other Comments: