Restaurant Information*
Date*
Other Suggestions
About Food Excellent Good Average Poor
Kind
Taste
Weight
Appearance
Temperature
Overall Impressions
Environment Excellent Good Average Poor
Tableware
Lobby environment
Washroom
Service Excellent Good Average Poor
Efficiency
Manners
Will you come to our restaurant next time?YesNo
Would you like to receive the newest holiday sales
events information?
YesNo
How often do you eat at restaurant?
Everyday More than once a week
Once a week Once a month
Guest name*
Tel*
E-mail*
What’s your favorite dish?
Western food Cantonese food Thai food Chinese food
Others
Sex MaleFemale    
Age 12-19 years old 20-29 years old
  30-39 years old 40-49 years old
Older than 50 years old
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