Survey

Welcome

Dear Customer:

Thank you for joining our VIP e-CLUB!

As a NEW MEMBER, we'd like to offer you a GIFT.

The next time you come into our restaurant, we'd like to offer you a 10% discount on your next meal. Just print out the coupon at the end of this registration form.

Looking forward to your visiting us!

Complete the following:

Complete the following: First Name
Last Name
Email

How did you hear of us? Check all that apply.

How did you hear of us? Check all that apply. A Friend

Newspaper

Phone Book

Web Search

Other

If "Other", please specify.

How well does the Coal Tower satisfy each element of your experience with us?

	Not Well	Somewhat Well	Well	Very Well
Ambience / Atmosphere	How well does the Coal Tower satisfy each element of your experience with us? Ambience / Atmosphere Not Well	Somewhat Well	Well	Very Well
Quality of Food	Quality of Food Not Well	Somewhat Well	Well	Very Well
Location	Location Not Well	Somewhat Well	Well	Very Well
Friendly Staff	Friendly Staff Not Well	Somewhat Well	Well	Very Well

Other (please specify)

What other ideas or comments do you have?

Thank you for joining us!

Sincerely,
Louis Gitsis

PS. PRINT the NEXT PAGE after you have completed this brief survey for your new VIP e-CLUB member 10% DISCOUNT COUPON. It's our way of thanking you for joining!

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