Full Name

Email Address

Check-in Date

Check-out Date

Room Number

Overall Experience 1 - Very Dissatisfied 2 - Dissatisfied 3 - Neutral 4 - Satisfied 5 - Very Satisfied

Room Cleanliness 1 - Very Poor 2 - Poor 3 - Average 4 - Good 5 - Excellent

Staff Service 1 - Very Poor 2 - Poor 3 - Average 4 - Good 5 - Excellent

Hotel Amenities 1 - Very Poor 2 - Poor 3 - Average 4 - Good 5 - Excellent

Additional Comments