Event Survey

First Name

Last Name

Address

Town/City

State

Zip Code

Daytime Phone Ext.

Email Address

Please list any food allergies, intolerances or special diets (Please be specific and describe fully)

Please check the box that best describes your feelings about the following food styles like/enjoy neutral dislike Contemporary French Italian Southwestern Greek Asian Comfort Food Jamaican Mexican

Please list foods in each category that you do not like Beef Pork Shellfish Fish Freshwater Fish Goat or Lamb Poultry Beans Grains/Rice Nuts Dairy Fruits/Vegetables Herbs Spices (seasonings, vinegars) Oils Pastas/Flour Liquor/Wine