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Name:
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Address:
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City:
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State:
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Zip Code:
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Phone:
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E-Mail Address:
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Fax:
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Persons in your household? (list children separately)
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Age of children?
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How did you hear about us?
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How many nights a week do you eat out / order in?
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Who does the cooking now?
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What time do you come home?
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How long can you / will you spend in the kitchen?
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Do you cook alone?
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Who cleans up?
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Who does the food shopping?
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Do you like to go food shopping?
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How often do you food shop?
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Do you use a list?
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How do you rate your knowledge of fresh produce?
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How do you rate your knowledge of fresh meat / fish?
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Approximately, what do you spend on groceries per visit?
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Do you have an additional refrigerator?
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How often do you entertain?
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When you entertain, how many people do you usually have?
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When you entertain, are you more casual or formal?
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Do you have any cookbooks? If so, please list:
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Of the cookbooks listed, which ones do you use most often?
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Please give an example of an average weeks dinner:
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• Monday
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• Tuesday
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• Wednesday
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• Thursday
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• Friday
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• Saturday
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• Sunday
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With your main course, do you serve:
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• Salad
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• Veggies (if yes, how many)
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• Dessert
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• Other
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Do you have any allergies?
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Are there any foods you are turned-off to?
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What is your favorite dinner(s)?
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What is your favorite cuisine?
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What is your favorite pasta?
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What is your favorite dessert?
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What is your favorite holiday meal?
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Would you like to entertain for the holidays?
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How do you rate your knowledge of cooking utensils?
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How do you rate your knowledge of kitchen appliances?
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Do you have a BBQ?
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Would you use it during the colder months?
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Additional Comments:
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