Form
Manager Dining Stipend Feedback
Please complete the following questions prior to turning in your receipt. If submitting multiple receipts, please complete a separate form.
Name
*
First Name
Last Name
Local Foods Location
*
Please Select
Rice Village
Upper Kirby
Tanglewood
Heights
Dining Date
*
-
Month
-
Day
Year
Date
Receipt Amount?
*
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Where did you dine?
*
If a multi-unit concept, please specify which location
How would you rate the food?
*
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5
How would you rate the service?
*
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4
5
How would you rate the venue?
*
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5
What did you eat/drink?
*
Tell us about your experience
*
Would you dine here again? Tell us why or why not.
*
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