Name:

Address:

City:

Zip Code:

E-Mail:

Cell Phone:

Date of Visit:

Day of Visit:

Select One Wednesday Thursday Friday Saturday Sunday

How was our Food Quality?

Does Not Apply Excellent Fair Poor

Which floor did you spend most of the time on?

Select One First Second

How would you rate our music volume?

Perfect Too Loud A Little Loud A Little Low Too Low

Excellent Fair Poor

How would you rate our music selection?

How would you rate our service?

Excellent Fair Poor

How would you rate the quality of our drinks?

Excellent Fair Poor

Based on the experience you had, would you return to Club Bravo?

Definitely Probably Probably Not No Way

Do you have any additional comments or suggestions for us?

How would you rate your overall experience?

Excellent Fair Poor