R E S T A U R A N T
S U R V E Y

              We Value Your Opinion!

Please participate in the Restaurant Survey and you will receive a

Free $10 Gift Certificate

To Dine Out in the Cambridge area!

         
A. Please select all restaurants below that you have visited at least once in the past year. Also Please rate these restaurants from #1 for best to #4:
    Great Good Average Poor
  THEO'S Coney Island #1 #2 #3 #4
 
Ruby Tuesday's
#1 #2 #3 #4
  Mr.Lees #1 #2 #3 #4
  Plus 1 Pizza #1 #2 #3 #4
  FORUM #1 #2 #3 #4
  Cracker Barrel #1 #2 #3 #4
  Bob Evans #1 #2 #3 #4
  The Point #1 #2 #3 #4
  Longbranch #1 #2 #3 #4
  Pizza Hut #1 #2 #3 #4
  Holiday Inn #1 #2 #3 #4
  Brighton's #1 #2 #3 #4
  China Village #1 #2 #3 #4
  La Bamba #1 #2 #3 #4
  USA Steak Buffet #1 #2 #3 #4
  Long John Silver's #1 #2 #3 #4
  Grand Buffet #1 #2 #3 #4
  House of Hunan #1 #2 #3 #4
  YOGI'S #1 #2 #3 #4
  Subway #1 #2 #3 #4
  McDonald's #1 #2 #3 #4
  Taco Bell #1 #2 #3 #4
  Wendy's #1 #2 #3 #4
  Burger King #1 #2 #3 #4
  K.F.C #1 #2 #3 #4
  Lanning's Family Restaurant #1 #2 #3 #4
B. One of my favorite restaurants not listed above is:
 
C. I frequently use the Yellow Pages to choose a restaurant:
  Yes     No
D.

Please fill out your two favorite radio stations:

WBIK

WILE AM 1270

WILE FM 97

KC105 FM

WCMJ 96 FM

 
 
E. I am: Female    Male
F. I am:
  under 25 years old
  25-39 years old
  40-49 years old
  50-59 years old
  over 60 years old
           
G. I have lived in the cambridge area:
 
less than 2 years 2-10 years
10-20 years over 20 years

Please don’t forget to completely fill in the form.

Name:
Address:
City:
Postal Code:
Phone Number:
Email:


BONUS GIFT CERTIFICATE !!

If you wish to receive an additional FREE Gift Certificate
each year for dining out during your birthday month,
please fill in the month of your birthday below:

Month of Your Birthday:
Month of Spouse's Birthday :
Spouse's Name :

 

  


Thank You For Your Participation -

Enjoy Your Free $10 Gift Certificate.

RESTAURANT SURVEY
PO BOX 1683 CAMBRIDGE, OH 43725
FAX (740) 439-9898