The Local Pub in New Jersey

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SURVEY

We value your feedback. Take this survey and be entered to win a
$100 Gift Card!

Name*
Date of Visit*
Phone
(###) - ### - ####
Reciept Number*
Email*
How did you learn about us?*
The name of your server:*
How many in your party?*
What did you order?
Did you*
Dine In Take Out
Breakfast Lunch Dinner
Hostess:*
Excellent Good Fair Poor
Bartender:*
Excellent Good Fair Poor
Quality of Food:*
Excellent Good Fair Poor
Accuracy of food:*
Excellent Good Fair Poor
Portion size:*
Excellent Good Fair Poor
Speed of service:*
Excellent Good Fair Poor
Cleanliness:*
Excellent Good Fair Poor
Would you return within 30 days?*
Yes No
Would you recommend The Local Pub & Eatery to others?
Yes No
Would you like a manager to contact you?*
Yes No
What would you like to see in our menu?*
What kinds of events would you like to see here?
Provide us your suggestions:*

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The Local Pub in New Jersey

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