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Email Address
Name
Mailing Address
City
State
Zip
Restaurant Visited
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Gibraltar
Barny's Grill
Lancaster Brewing Company
Date Visited
mm/dd/yyyy
Number in Party
Lunch or Dinner
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Lunch
Dinner
Server Name
How often do you dine with us?
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First Time
Once in a while
Regularly
Which entrees did you select?
How did you hear about us?
Please rate the items below. 5 = Superior, 1 = Poor
Were you treated in a friendly manner?
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5
4
3
2
1
Food Quality
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5
4
3
2
1
Food Presentation
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5
4
3
2
1
Service
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5
4
3
2
1
Promptness
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5
4
3
2
1
Food and service compared to pricing
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5
4
3
2
1
Overall, how do you feel about your visit?
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5
4
3
2
1
Additional Comments
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GIBRALTAR
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BARNY'S GRILL
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LANCASTER BREWING COMPANY
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COMEDY ZONE
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GIBRALTAR
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BARNY'S GRILL
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COMEDY ZONE
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