Conway Dine-in Survey - 2

Question Title

* 1. $50 GIFT CERTIFICATE AWARDED WEEKLY! To enter this weekly drawing use your receipt to enter the following information. If you do not wish to participate in the drawing you are welcome to leave this section of the survey blank.

Date

Time

Ticket Number

Server Name

Server #

Question Title

* 2. What did you order?

Question Title

* 3. Please describe the quality of your food:

	Excellent	Very Good	Satisfactory	Needs Improvement	Poor
Flavor	Flavor Excellent	Flavor Very Good	Flavor Satisfactory	Flavor Needs Improvement	Flavor Poor
Texture	Texture Excellent	Texture Very Good	Texture Satisfactory	Texture Needs Improvement	Texture Poor
Appearance	Appearance Excellent	Appearance Very Good	Appearance Satisfactory	Appearance Needs Improvement	Appearance Poor

Comments:

Question Title

* 4. Did you receive your food in a timely manner?

Yes

No

Comments:

Question Title

* 5. Compliments on our staff

Question Title

* 6. Please rate your overall experience with Stoby's on your most recent visit.

	Excellent	Very Good	OK	Needs Improvement	Poor
Food	Food Excellent	Food Very Good	Food OK	Food Needs Improvement	Food Poor
Service	Service Excellent	Service Very Good	Service OK	Service Needs Improvement	Service Poor
Cleanliness	Cleanliness Excellent	Cleanliness Very Good	Cleanliness OK	Cleanliness Needs Improvement	Cleanliness Poor

Question Title

* 7. Please describe the service you received:

	Strongly Agree	Agree	Disagree	Strongly Disagree	N/A
Appetizers Prompt	Appetizers Prompt Strongly Agree	Appetizers Prompt Agree	Appetizers Prompt Disagree	Appetizers Prompt Strongly Disagree	Appetizers Prompt N/A
Refills Regular	Refills Regular Strongly Agree	Refills Regular Agree	Refills Regular Disagree	Refills Regular Strongly Disagree	Refills Regular N/A
"Checked on" often	"Checked on" often Strongly Agree	"Checked on" often Agree	"Checked on" often Disagree	"Checked on" often Strongly Disagree	"Checked on" often N/A
Final Ticket Prompt	Final Ticket Prompt Strongly Agree	Final Ticket Prompt Agree	Final Ticket Prompt Disagree	Final Ticket Prompt Strongly Disagree	Final Ticket Prompt N/A

Name of Server and comments:

Question Title

* 8. We need your suggestions on how to make Stoby's better. We would greatly appreciate your honest feedback and candid input. We can not improve Stoby's 100% but we are certain that with your help we can improve 1% a hundred times.

Question Title

* 9. Did you know Esquire Magazine in it's March 2009 issue named Stoby's among the 59 best place to eat breakfast in America?

Yes

No

Question Title

* 10. Would you recommend Stoby's?

Absolutely - and I do often

Yes

Yes - with reservations

No

Comments:

Question Title

* 11. How may we contact you if you win the WEEKLY drawing?

Name:

Company:

Address:

City/Town:

State:

ZIP/Postal Code:

Email Address:

Phone Number:

Question Title

* 12. E-Club - Would you like to join Stoby's E-Club? We promise to keep your contact information strictly confidential.

Yes

No

100% of survey complete.