SAMPLE - Employee Transportation Survey

Please complete this confidential survey describing your commute for the past week.


1.

What is your home ZIP CODE?

2.

What is the one-way distance between your home and the place where you work?

Miles

3.

What time did you usually get to work during the survey week?

Before 6 am
6:00-6:59 am
7:00-7:59 am
8:00-8:59 am
9:00-9:59 am
10:00 am or later

4.

What time did you usually leave work during the survey week?

Before 3 pm
3:00-3:59 pm
4:00-4:59 pm
5:00-5:59 pm
6:00-6:59 pm
7:00 pm or later

5.

How did you get to work each day of the survey week? (If you used more than one way, please indicate the way for the longest part of your trip.)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

6.

If you get to work in a carpool or vanpool, how many people are in the vehicle (including yourself)?

7.

If you drive to work, what kind of vehicle do you drive?

Small to Midsized car (not hybrid)
Truck/SUV (not hybrid)
Hybrid (all models)
Electric (all models)

8.

If you drive to work, what average mileage do you get?

Miles per gallon

9.

What is most important to you when you choose how you get to work? (Select up to 3)

Travel Time
Cost
Convenience/Flexibility
Reliability
Comfort and Safety
Reducing pollution, conserving energy
Ability to make stops on the way to work or home
Stress

10.

If you usually drive alone to work, what other ways would you be willing to try? (Select up to three)

Carpool
Vanpool
Transit
Bike
Walk
Work at home for a regular work day

11.

If you usually drive alone to work, why don't you use other ways (like carpooling, transit, biking or walking) to get to work? (Select up to 3)

Transit service doesn't match my route/schedule
Difficult to find others to carpool/vanpool
Work late or irregular hours
Cannot get home in an emergency
Poor bike/walk access
Use my car on the job
Need to make stops on the way to work or home
Prefer to drive my own car

12.

If you usually drive alone to work, what would encourage you to use a different way to get to work (like carpooling, transit, biking or walking)? (Select up to 3)

Financial incentives
Guaranteed ride home in an emergency
Awards/prizes
Transit passes sold at work
Help with transit information
Shuttle between transit station and work place
Special parking for carpools/vanpools
Help finding carpool/vanpool partners
Bike lockers/showers at work
Better bike/walk access
Work schedule flexibility
On-site services (like banking, convienience store, dry cleaning)

Feel free to share any additional comments about your trip to work:

 


I'd like a free Matchlist of carpool, vanpool, or bicycle referrals.

Complete this optional section for a free list of carpool, vanpool, or bicycle partners who live and work near you. Your home and work address will remain strictly confidential and are used for ridematching purposes only. The 511 Regional Rideshare Program provides referral services. It does not certify the character of ridesharing participants. Participants are advised to screen referrals to their personal satisfaction. 511 Regional Rideshare Program does, however, within the lawful limits of title VI of the civil rights act of 1964, as amended, reserve the right to refuse services to anyone.

If you are not interested, please scroll to the end of the survey and click on the "click here to finish" button.

First Name

Last Name

Home Address

Home City

Home Zip Code

Home Phone

What is your commute preference?

I want to Drive and add passengers to my car
I want to Ride and join a carpool or vanpool as a passenger
I want to join a carpool or vanpool as a driver or passenger
I want to join other bicyclists in a bikepool
I want to join other bicyclists and carpool

I'm interested in bike commuting referrals. (check as many as you like)

My riding level is: Novice Some Experience Experienced
I am available to help other riders with advice
I am seeking a riding partner
I am seeking an experienced rider for advice

Do you drive a vanpool?

No
No, but I would like to
Yes, and I am seeking riders
Yes, but I am not seeking riders

Employer

Work Address

Work City

Work Zip Code

Work Phone

E-mail Address

What time do you usually start work?

hr:mn format

AM or PM?

am
pm

What time do you usually leave work?

hr:mn format

AM or PM?

am
pm

Are the hours you work flexible at all?

yes
no

By how much? (in minutes)

Minutes