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* 1. Name:

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* 2. Address:

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* 3. Phone Number:

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* 4. Number of kids in household:

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* 5. Does anyone play golf in your household?

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

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

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

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