Times Square

Limit one person per email address. If you are registering using a Comcast, Juno, Netzero, or Facebook email address, please note that these providers may block email from Benihana including the Birthday Certificate. If possible, register using an alternate email address. Arigato!

Email:

Address Line 1:

Address Line 2:

Zip:

Birthday:

Favorite Location:
AddisonAlpharettaAnaheimAnchorageAtlanta I (Buckhead)BeavertonBethesda IIBoca RatonBroomfieldBurlingameCarlsbadChandlerCherry HillChicagoCincinnati IClevelandColumbusConcordConroeCoral GablesCoral SpringsCupertinoDallasDearbornDenverDowneyDullesEdisonEncino, CAFarmington HillsFort LauderdaleHouston I (Downtown)Houston II - WestheimerIndianapolisKey WestLas ColinasLas VegasLAS VEGAS – WESTGATE RESORT AND CASINOLombardMall Of AmericaManhassetMaple GroveMemphisMiami BeachMilwaukeeMinneapolisMiramarMontereyNewport BeachNorth Little RockNY West, NYOntarioOrlandoOrlando I (Hilton)PittsburghPlanoPlymouth MeetingPuente HillsSalt Lake CitySan DiegoSan FranciscoSan MateoSanta AnitaSanta MonicaScottsdaleScottsdaleShort Hills, NJStuartSugar LandTemeculaTorranceTroyWestburyWheelingWoodlands

Phone:

Gender:
MaleFemale

How often do you visit?:
Once a MonthOnce Every 2-3 MonthsOnce Every 3-6 MonthsOnce Every 6-12 MonthsEvery Year For Your BirthdayRarely/Never

When do you usually visit Benihana? (check all that apply):
LunchDinnerHappy HourTake-out & DeliveryCatering

What are your favorite types of dishes on our menu?
ChickenLobsterScallopsShrimpSalmonSteakSushiTunaVegetarian

Which alcoholic beverages do you enjoy the most at Benihana?
WineSakeSpeciality CocktailsBeerI do not drink alcohol at Benihana

When do you enjoy dining at Benihana?
Special OccasionsFamily DinnerDinner with FriendsDate NightHappy HourBusinessOther

I have read and agree to your privacy policy and understand how my data might be used.