Caribbean Cuisine Registration and Survey Form

Win a FREE DINNER FOR TWO at Caribbean Cuisine!

Please help us make your experience at Caribbean Cuisine even more enjoyable. Your comments are the best way for us to keep improving our service to you. And to thank you for being one of our valued customers, you could win a dinner for two at Caribbean Cuisine, drawn monthly.

All information is kept confidential and will never be sold to a third party.

First, please introduce yourself:

First Name

Last Name

Title

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

E-mail

When is your birthday? (for birthday promos and special offers)

How would you rate us?

bad poor average fair good

How often do you dine here?

Too often, but I can't help myself
Two or three times a week
Every other week
Once a month
Only when I'm in the area, which isn't often
This was my first time

Which location did you visit or order from? (please check all that apply)

East Orange
West Paterson
I don't know, I wasn't the one who ordered the food
Neither, it was shipped via FedEx

What do you like least at Caribbean Cuisine?

What do you like best at Caribbean Cuisine?

What can we do to improve our service to you?

Would you like us to include your name on our list of special customers to inform you of any special events at Caribbean Cuisine?

Thank you very much for your comments!

Copyright © 1999 by Caribbean Cuisine. All rights reserved.
Revised: August 18, 2003

First Name
Last Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
E-mail

Thank you very much for your comments!

Copyright © 1999 by Caribbean Cuisine. All rights reserved. Revised: August 18, 2003

Copyright © 1999 by Caribbean Cuisine. All rights reserved.
Revised: August 18, 2003