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Contact Information
First Name : 
Last Name : 
Phone : 
Email Address : 
 
 
 
Date of birth?
 
 
 
Postal code:
   
 
 
 
Gender
 
Male
 
Female
 
Rather not say
 
 
 
How often do you dine at Le Sand-wich?
 
1 to 3 times per week
 
3 to 5 times per month
 
Once per month
 
First time
 
 
 
Occupation
   
 
 
 
How did you find out about Le Sand-wich?
 
Website
 
Online review
 
Passing by
 
Flyer
 
Friend
 
Other
 
 
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