Please fill up all the fields in this form, your help would be appreciated! * the first 100 people will receive a free gift * Would you mind spending a little bit more to go to a place that you like? (eg. Restaurant, Cafe ...)Yes No Perhaps Would you go to a non-alcoholic Restaurant/Cafe?Yes No Perhaps You prefer a ... (smoking area will be reggregated)Non-smoking area Smoking area Don't mind Do you always have your lunch at home? (On average)Yes No Do you always have your dinner at home? (On average)Yes No You mostly spend your weekends with yourFamily Friends Business Associates Depands on sitiuation (mixture of all three) Do you have Internet access at home?Yes No How long do you spend on the Internet per day? ***Please select one*** Less than an hour 1-2 hours 2-3 hours 3-4 hours 4-5 hours 5-6 hours 6-7 hours 7-8 hours 8-9 hours 9-10 hours More than 10 hours If the facility of Internet access is provided at a Restaurant/Cafe, would you use it?Yes No Tell us something about what you like. (You may select more than one) Entertainment Home & Family Health Music Shopping Sports & Outdoors Business Computers & Technology Personal Finance Small Business Travel Please tell us the thing(s) you hate most when you visit any Restaurant/Cafe:(Optional) Please state your occupation as it is very important to this survey. ***Please select one*** executive/managerial professional (doctor, lawyer, etc.) academic/educator computer technical/engineering other technical/engineering service/customer support clerical/administrative sales/marketing tradesman/craftsman college/graduate student homemaker self-employed/own company unemployed, looking for work retired other If you want to enter our lucky draw or receive the latest news about our activities, please fill in your details: (your details will not be released to any third party) Full Name: Gender: ***Please select one*** male female Other Year of Birth: Marital Status: ***Please select one*** Single Married Other No. of Children: ***Please select one*** 0 1 2 3 4 5 6 7 8 9 10 More than 10 Monthly Income: ***Please select one*** Below RM1,000 RM1,000 - RM2,000 RM2,001 - RM3,000 RM3,001 - RM4,000 RM4,001 - RM5,000 RM5,001 - RM6,000 RM6,001 - RM7,000 RM7,001 - RM8,000 RM8,001 - RM9,000 RM9,001 - RM10,000 More than RM10,000 E-mail: Mailing Address:
Would you mind spending a little bit more to go to a place that you like? (eg. Restaurant, Cafe ...)Yes No Perhaps
Would you go to a non-alcoholic Restaurant/Cafe?Yes No Perhaps
You prefer a ... (smoking area will be reggregated)Non-smoking area Smoking area Don't mind
Do you always have your lunch at home? (On average)Yes No
Do you always have your dinner at home? (On average)Yes No
You mostly spend your weekends with yourFamily Friends Business Associates Depands on sitiuation (mixture of all three)
Do you have Internet access at home?Yes No
How long do you spend on the Internet per day? ***Please select one*** Less than an hour 1-2 hours 2-3 hours 3-4 hours 4-5 hours 5-6 hours 6-7 hours 7-8 hours 8-9 hours 9-10 hours More than 10 hours
If the facility of Internet access is provided at a Restaurant/Cafe, would you use it?Yes No
Tell us something about what you like. (You may select more than one)
Please tell us the thing(s) you hate most when you visit any Restaurant/Cafe:(Optional)
Please state your occupation as it is very important to this survey. ***Please select one*** executive/managerial professional (doctor, lawyer, etc.) academic/educator computer technical/engineering other technical/engineering service/customer support clerical/administrative sales/marketing tradesman/craftsman college/graduate student homemaker self-employed/own company unemployed, looking for work retired other
If you want to enter our lucky draw or receive the latest news about our activities, please fill in your details: (your details will not be released to any third party)
Full Name: Gender: ***Please select one*** male female Other
Year of Birth:
Marital Status: ***Please select one*** Single Married Other No. of Children: ***Please select one*** 0 1 2 3 4 5 6 7 8 9 10 More than 10
Monthly Income: ***Please select one*** Below RM1,000 RM1,000 - RM2,000 RM2,001 - RM3,000 RM3,001 - RM4,000 RM4,001 - RM5,000 RM5,001 - RM6,000 RM6,001 - RM7,000 RM7,001 - RM8,000 RM8,001 - RM9,000 RM9,001 - RM10,000 More than RM10,000
E-mail:
Mailing Address:
