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Customer Comment Card

We know you have a lot of choices when you go out on the town.  If there's anything we can do to make the County Line experience better for you, please let us know.

Note: Fields marked with a * are required.

Which restaurant did you visit? * 
 
When did you visit us? *  DATE:   Lunch Dinner  TIME: AM  PM
 
Who served you?     SERVER: Male Female    Name:
 
Food Quality *   
 
Service *   
 
Value *   
 
Cleanliness  *   
 
Explanations / Suggestions:
 
Tell us about yourself:
 
Name:   Birthday:  
Address:  

Favorite Radio Station(s):

 
 
City:   State:

Zipcode:

Phone:   E-Mail:
 
What event brought you to eat at the restaurant?
Business
Family get-together
Celebration
Hungry for BBQ
Other - please list:
 
How did you first find out about us?
Print Ad
T.V.
Radio - which station?:
Friend
Relative
Other - please list:

Fill out the entire form, and be entered into a drawing for a dinner for 4!

Thanks for takin' the time to let us know how we're doin'!