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SURVEY.TRC
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1996-07-18
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Restaurant Survey - Information
────────────────────────────────────────────────────────────────────────
RESTAURANT NAME ______________________________________________________
ADDRESS ______________________________________________________________
CITY __________________________ STATE _____ ZIP CODE _______-______
PHONE NUMBER (______) ______-________
Please "X" the following one that apply:
────────────────────────────────────────
MEALS SERVED: Breakfast [ ] Lunch [ ] Dinner [ ]
CREDIT CARDS ACCEPTED: Visa [ ] Master Card [ ] American Express [ ]
FOOD DELIVERED HOW?: Dine in [ ] Carry out [ ] Delivery [ ]
Answer the following with numbers from the chart below:
───────────────────────────────────────────────────────
┌ Price ──────┐ ┌ Cuisine ────┐ ┌ Capacity ───┐ ┌ Attire ──┐
[ ] $1 - $3 │ [ ] Italian │ [ ] 1 - 25 │ [ ] Formal│
[ ] $3 - $5 │ [ ] Greek │ [ ] 25 - 50 │ [ ] Casual│
[ ] $5 - $10 │ [ ] Spanish │ [ ] 50 - 100 │ └──────────┘
[ ] $10 - $20│ [ ] American │ [ ] 100 - 200│ ┌ Smoking ┐
[ ] $20 - $50│ [ ] Seafood │ [ ] 200+ │ [ ] Yes │
[ ] $50 + │ [ ] Chinese │ └─────────────┘ [ ] No │
└─────────────┘ [ ] Deli │ └─────────┘
[ ] Bakery │ ┌ Reservation ┐
[ ] Bar │ [ ] Yes │
└─────────────┘ [ ] No │
└─────────────┘
ADDITIONAL COMMENTS: ______________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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