Sponsors Of

knbr 1050 sports leader

49ers Broadcast

Black Bear Diner

E-COMMENT CARD

* Restaurant Location:
* Date of Visit:
* Time Of Day
Server Name

	Excellent	Above Average	Average	Below Average	Poor
* Overall, how was your experience
* Service Overall
* Speed Of Service
* Friendliness Of Employees
* Employee Appearance
* Food Quality Overall
* Temperature Of Food
* Taste Of Food
* Value For Money
* Cleanliness Overall
* Cleanliness Outside The Diner
* Cleanliness In The Dining Area
* Cleanliness Of The Restrooms

	Very Likely	Somewhat Likely	Not Sure	Somewhat Unlikely	Very Unlikely
* How likely are you to return to this Black Bear Diner?
* How likely are you to recommend this Black Bear Diner to others?

Please elaborate on your dining experience (optional):


* Name:
* Address:
* City:
* State:
* Zip:
* Phone:
* E-mail:

* May we contact you regarding the feedback you submitted?	YesNo
Keep me informed. Send me emails with information and offers about Black Bear Diner.

* Required. Did you complete all the required fields? Please check. Personal information is for internal use only.
You will not be contacted unless you have given us permission to do so.