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* 1. What was the date of your visit?

Date

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* 2. How likely are you to recommend the Moot House?

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* 4. Which menu items did you order today?

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* 5. Please rate the following:

  Very Poor Poor Okay Good Excellent
Timeliness
Taste
Service
Overall Value
Atmosphere
Cleanliness

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* 6. Did a manager visit your table?

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* 7. Comments:

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* 8. Contact Info

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* 9. Would you like to receive our enewsletter?

T