Dining Acknowledgement Form
Thank you for dining with us this evening!
Name
*
First Name
Last Name
Member or Guest Account Number
*
Email
*
example@example.com
I was presented with a receipt that reflected an accurate total plus gratuity that I agreed to pay at the conclusion of my dinner service.
*
Yes
No
Signature
Clear
Would you like to complete a short survey about your experience tonight?
Yes
No
Food Quality
1
2
3
4
5
Unsatisfied
Satisfied
1 is Unsatisfied, 5 is Satisfied
Friendliness of Service
1
2
3
4
5
Unsatisfied
Satisfied
1 is Unsatisfied, 5 is Satisfied
Timeliness of Service
1
2
3
4
5
Unsatisfied
Satisfied
1 is Unsatisfied, 5 is Satisfied
Additional comments:
Submit
Should be Empty: