1) Are you a:

Undergraduate student   Graduate Student   Faculty   Staff   Other

2) How often do you visit the Filling Station?

Daily   Once a week or more   Once a month or more   This is the first time

3) What meal do you normally eat?

Breakfast   Lunch   Dinner   Snack

4) How satisfied are you with the selection of food?

Extremely Dissatisfied

Dissatisfied

Indifferent

Satisfied

Extremely Satisfied

5) How satisfied are you with the quality of food?

Extremely Dissatisfied

Dissatisfied

Indifferent

Satisfied

Extremely Satisfied

6) What other items would you like to see?

7) How satisfied are you with the customer service?

Extremely Dissatisfied

Dissatisfied

Indifferent

Satisfied

Extremely Satisfied

8) How satisfied are you with the atmosphere?

Extremely Dissatisfied

Dissatisfied

Indifferent

Satisfied

Extremely Satisfied

9) Is there anything specific that you would like to change about the atmoshpere (decorations, music, set up, etc.)?

10) List any other suggestions that you have here