Thank you for visiting us at Mary Brown's! To continue to try and serve you better, we would appreciate your input.

1. Who made the decision to come to Mary Brown's today? (Please check all that apply):

Me	Other adult family members
Spouse/partner/boyfriend/girlfriend	Co-workers/people at work
Friends	Team/group/club/church
Children	Other (Please specify)
Parents

2. Are you having Mary Brown's today (Please check only one):

For lunch (around noon)

For supper

For a snack or treat during the day

For a late night snack or meal (9 p.m. or later)

3. Why did you choose Mary Brown's today? (Please check all that apply; if more than one, please rank your reasons, 1, 2, 3, etc. with 1 being the most important reason):

Coupons or special discounts	1 2 3 4 5 6 7 8 9 10
Convenient location	1 2 3 4 5 6 7 8 9 10
Fast, efficient service	1 2 3 4 5 6 7 8 9 10
Variety of items on the menu	1 2 3 4 5 6 7 8 9 10
Great tasting food	1 2 3 4 5 6 7 8 9 10
Offers healthier items on the menu	1 2 3 4 5 6 7 8 9 10
Clean, well-kept premises	1 2 3 4 5 6 7 8 9 10
Uses fresh ingredients	1 2 3 4 5 6 7 8 9 10
A good place for families, or to take kids	1 2 3 4 5 6 7 8 9 10
Good value for the money	1 2 3 4 5 6 7 8 9 10

4. Using a scale of 1 to 10, where 1 means "very poor" and 10 means "excellent", how would you rate your experience today? (Please select one number for each):

Fast, efficient service	1 2 3 4 5 6 7 8 9 10
Friendly, helpful service	1 2 3 4 5 6 7 8 9 10
Great tasting chicken	1 2 3 4 5 6 7 8 9 10
Clean, well-kept premises	1 2 3 4 5 6 7 8 9 10
Food that's freshly made when you order	1 2 3 4 5 6 7 8 9 10
Uses fresh ingredients	1 2 3 4 5 6 7 8 9 10
A good place for families or to take kids	1 2 3 4 5 6 7 8 9 10
Large portion sizes	1 2 3 4 5 6 7 8 9 10
Don't know	1 2 3 4 5 6 7 8 9 10

5. Are you: FEMALE or MALE

6. In which of the following age categories do you belong:

18-24	45-54
25-34	55-64
35-44	65+

7. How many people 17 years of age or younger live in your household?

What are their ages? ; ; ;

8. Which of the following best describes your current situation?
(Please check only one):

Employed (Please describe your occupation)

Unemployed

Retired

Homemaker

Student

Other (Please specify)

9. Which of the following best describes the highest level of education that you have completed? (Please check only one):

Elementary school	Some University
Some High School	Graduated University (Undergrad)
Graduated High School	Post Graduate University (Masters, Ph.D)
Vocational/Technical College

10. Which of the following broad income categories best describes your total annual household income...that is, all income earners before taxes and other deductions? (Please check only one):

Less than $20,000	$60,000 to less than $80,000
$20,000 to less than $40,000	$80,000 to less than $100,000
$40,000 to less than $60,000	$100,000 or more

11. What is the postal code (if not known, community) where you reside?


12. When you visit Mary Brown's, which of the following best describes what you usually do? (Please check only one):

Order a meal

Use a coupon

Take advantage of special offer (e.g. limited time special)

Order regular priced individual items on the menu

13. Which of the following best describes how often you eat Mary Brown's (Please check only one):

At least once a week

2-3 times a month

About once a month

Less than once a month

Today is my first Mary Brown's experience