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Subject		----- CHOOSE ONE ----- Opportunity for Improvement General Concern Positive Experience
Choose a location		----- CHOOSE A LOCATION ----- Elsa's® Kettering Sports Grill Elsa's® East Elsa's® South Elsa's® On The Border Elsa's® Corner Cantina *
First Name		*
Last Name		*
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Email Address		*
Confirm Email		*
Restaurant Visit Information
Date of Visit		Select Month January February March April May June July August September October November December Day 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 Year 2014 2020
Time of Visit		Hour 1 2 3 4 5 6 7 8 9 10 11 12 Minutes 00 15 30 45 PM AM
Employee Name
Employee Position		----- CHOOSE ONE ----- Host Server Bartender Manager
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