* 1. Name:

* 2. Address:

* 3. Phone Number:

* 4. Number of kids in household:

* 5. Does anyone play golf in your household?

* 6. How many times a week does your family eat out?

* 7. What items would you like to see on our menu, if not all ready on it?

* 8. Would you order take-out from our grill if we offered it?

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