Gold Star Chili :: Satisfaction Survey

Gold Star Chili Menu

Untitled Document

Let us know how we're doing

Please describe your visit with as much detail as possible to
help us keep up the best quality for you.

Date:

Time (Please note AM or PM):

Location:

Server's Name:

What did you order:

Quality	Good	Bad		Good	Bad
Good Value			Taste
Quality of food			Portion
Temperature of food			Appearance of food
Service
Speed			Hospitality
Accuracy			Appearance of server
Cleanliness
Inside store
Outside store
Rest rooms

What radio station(s) do you listen to most often?

How would you rate your overall dining experience?
(10 rating = excellent, 1 rating = poor)

Comments/Questions:

First Name:

Last Name:

Email:

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Address (Optional):

Phone (Optional):