Customer Feedback Form Question Title * 1. What is your first name? (Required.) Question Title * 2. What is your last name? (Required.) Question Title * 3. Please can we take your email address? (Required.) Question Title * 4. Which Restaurant did you visit? (Required.) Addlestone Boxhill Chichester Horsham Lingfield Tilgate Park Tunbridge Wells Ranch Rooms - Tunbridge Wells Hotel Question Title * 5. Please enter the date you visited us... (Required.) This can be found on the bottom of your receipt. Date Question Title * 6. Please enter the time you visited us... (Required.) This can be found on the bottom of your receipt. Time AM/PM - AM PM Question Title * 7. Did you have a booking reference number (if you made a booking in advance)? Question Title * 8. Did you use the Smith & Western app? Yes No Question Title * 9. Please upload a copy of your receipt here (Required.) Question Title * 10. What was your table number? (Required.) Question Title * 11. What was your server's name? (Required.) Question Title * 12. Please state which area your feedback is regarding... (Required.) Service Food Beverage Other Question Title * 13. What Items did you order? (Required.) Question Title * 14. Did you receive a check back on your food/ drinks? (Required.) Yes No Question Title * 15. Please let us know your feedback below: (Required.) Question Title * 16. Additional Attachments Send
