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What is your name?

Date of visit:

Time of visit:

Visit Type:Eat-InTakeout

If Eat In, number of people in party (# Adults, # Children under 18):

If Eat In, did you dine in main dining area or game room?Dining AreaGame Room

What menu items did you order?

How was the quality of the food?

Was the wait time for your order acceptable?YesNo

Was the restaurant clean and orderly?YesNo

Were the restrooms clean and orderly?YesNo

Was the staff friendly?YesNo

Was there any staff member you would like to commend?

Were you greeted upon entering and thanked upon leavingYesNo

Do you have a Comment, Suggestion or Complaint?CommentSuggestionComplaint

Please explain in more detail:

Would you like a return phone call or e-mail reply?Phone CallE-MailNo Reply Please

If phone call preferred, list phone number where you reached:

If e-mail response preferred, please supply e-mail address:

Favorite menu item:

Provide e-mail address and birthday to receive Donte’s Web Only Specials:

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