SURVEY QUESTIONNAIRE

Name: (optional)    ________________                      Address: ______________

Occupation: __________________            Age: _______________

Instruction: Please indicate your level of satisfaction with each statement listed below. 
Place a check (/) in the box of your answer. Your answers will be kept strictly confidential and
you will not be identified. 
Rating Equivalent: 
5 – Extremely Satisfied 3 – Neutral 1 – Not at All Satisfied
4 – Very Satisfied 2 – Slightly Satisfied

Casa Blanca : Best Seller

Baby Back Ribbs Extremely Very Neutral Slightly Not at all

Satisfied Satisfied 3 Satisfied Satisfied
5 4 2 1

Presentation
Taste
Originality

Graceland : Best Seller

Bicol Express Extremely Very Neutral Slightly Not at all

Satisfied Satisfied 3 Satisfied Satisfied
5 4 2 1

Presentation
Taste
Originality

Jane’s Fastfood Restaurant : Best Seller

Lomi Extremely Very Neutral Slightly Not at all

Satisfied Satisfied 3 Satisfied Satisfied
5 4 2 1

Presentation
Taste
Originality

Maxxims : Best Seller

Pancit Guisado Extremely Very Neutral Slightly Not at all

Satisfied Satisfied 3 Satisfied Satisfied
5 4 2 1

Presentation
Taste
Originality

Rosario’s Café and Restaurant

Lomi Extremely Very Neutral Slightly Not at all

Satisfied Satisfied 3 Satisfied Satisfied
5 4 2 1

Presentation
Taste
Originality