Your Name: Your E-Mail: Date of visit: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2007 Time: : AM PM Servers Name (optional): Cleanliness (1 = bad and 5 = excellent): 1 2 3 4 5 Food (1 = bad and 5 = excellent): 1 2 3 4 5 Service (1 = bad and 5 = excellent): 1 2 3 4 5 First time at East Bay Grille? Yes  No  Would you return? Yes  No  Would you tell a friend? Yes  No  How you heard about us? What would you like to see us change? Comments: