Address:
State:	Please Choose Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennysylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Email Address:
Gender:	Please Choose Male Female

Age Range:	20-25	26-30	31-35	36-40	41-50
		51-60	61-and then some

How did you hear about us?

Background

Education (check all that apply):
	Culinary School
	Restaurant Management School
	Apprenticeship Program
	School of Hard Knocks. Want to see the bruises?
	Other (explain)
Restaurant Experience Level (check one):
	Worked in a restaurant 1-5 years
	Worked in a restaurant 6-10 years
	Worked in a restaurant 11-20 years
	Worked in a restaurant 20+ years
	Have just eaten in restaurants
Current Position/Title:
What keeps you up at night We're asking these questions so that we can better understand the areas of concern you may have. If we can, we would like to help you sleep better at night. I have nightmares concerning my employees because of (check any boxes that apply)
	Employee staffing
	My employees don't understand I'm running a business
	Employee turnover
In my bad dreams there is (check any boxes that apply)
	Food waste
	Food inconsistency
	Food cost is out-of-control
	I think I loose money on my current menu
	Not enough inventory one night...too much the next
Late in the night (check any boxes that apply)
	I wonder if my vendors are giving me the best prices
	I wonder how to keep track of my vendors
I sometimes wake up in a cold sweat worrying about (check any boxes that apply)
	My POS system and its cost
	Cash flow management
	Should I expand the business
	How do I build customer loyalty
	My kitchen equipment failing on a Saturday night
	Why I can't take a day off; because the business controls me
Nextaurant can best help me (check one)
	In a bunch of small areas or with some good advice
	Run an overall tighter operation
	With a total overhaul, come quick
	Expand into new horizons
Computer Literacy (check one)
	My little cousin helps me turn the machine on (little or no experience)
	Use the computer for some restaurant functions and email but that's it (some experience)
	My copy of "Hackers Weekly" is well worn (lots of experience)
Restaurant Statistics We don't know you. That's why we're asking these questions. You don't know us. That's why you may not want to answer the following questions. We understand. But you should know that any thing you tell us we will hold in strictest confidence. We would never sell your name or information to another company. We're only asking because the more we know about you the quicker we can help. Type of restaurant
Name of Restaurant (optional)
Cuisine
Type of Service (check all that apply)
	Breakfast   Lunch   Dinner
Days of Operation
Size of Restaurant / total seats
Number of Employees
	Total   Full-Time   Part-Time
Total Covers per week
Check Average
$
Food Cost Percentage
	%
Cost of Labor Percentage
	%
History of restaurant (check all that apply)
	Built it	Bought it
	Own it	Run/Manage it
Number of years restaurant in existence
How profitable do you think you are (check one)
	The Titanic had a better chance (0%)
	We get a decent wage and we pay our bills on time (0-4%)
	We have a decent bottom line but we could do better (5-11%)
	We have a good bottom line but still have some serious headaches (12-35%)
	Our bottom line is amazing; we have plans to buy the hope diamond but could always use help to maintain it (35% +)