Comment Card

Date:*

Today

Date of your visit.

Meal Period:*

Name of Server:

Please rate the quality of your beverage:*

Please select from the drop down list.

Please rate the quality of your food:*

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Please rate our service:*

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Please rate your overall experience:*

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Please provide any additional feedback or comments.:

Note: You can expand this window by clicking on the bottom right corner and dragging downwards.

Name:

Please provide your name and e-mail if you wish a response from the House Committee.

E-mail:

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Security code:*

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