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Day Of Birth
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Month Of Birth
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February
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April
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August
September
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December
Please choose a number to rate us
(where 1 is poor and 5 is excellent)
Service
1
2
3
4
5
Food Quality
1
2
3
4
5
Atmosphere
1
2
3
4
5
Cleanliness
1
2
3
4
5
Value for money
1
2
3
4
5
Staff Friendliness
1
2
3
4
5
Your expirience was:
Dine-in
Delivery
Take away
Did the manager visit your table?
Yes
No
What do you like more about us?
How often do you visit us?
How did you hear about us?
Could your experience be any better
Yes
No
If yes, how?
Comments on your experience at our establishment
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