In an effort to better serve you, we ask that you fill out this form with your comments. It is your feedback that gives us the opportunity to make every Connie's Pizza experience a pleasant one.

Thank you for your patronage.

Date of visit:	Jan Feb March Apr May June July Aug Sept Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2006 2007 2008
Location:	--choose one-- Archer Avenue, Chicago Hyatt Pizzeria and Pub Navy Pier McCormick Place Orland Park Westmont Naperville Pazzini - Algonquin Pazzini - The Mart
Name:
Address:
City:		State:		Zip:
Email:
Food:
Taste	--choose one-- excellent good fair poor
Presentation	--choose one-- excellent good fair poor
Items Ordered
Service
Friendliness	--choose one-- excellent good fair poor
Attentiveness	--choose one-- excellent good fair poor
Knowledge	--choose one-- excellent good fair poor
Atmosphere	--choose one-- excellent good fair poor
Cleanliness	--choose one-- excellent good fair poor
Value	--choose one-- excellent good fair poor
Where did you eat your Connie's meal?: dine-in carry-out  delivery
Name of Connie's employee who served you:
Additional comments:

Please review that this form is filled out completely and then to us.