KB2WD2012 Survey

Please register now for Keweenaw Bike to Work Day 2012, Friday, May 18, 2012.

If you plan to take at least one trip to work, school or errands by cycling, walking, or other human-powered mode in Houghton County or Keweenaw County on Friday, May 18, 2012, or, if you cannot do so on May 18 but plan to do your non-motorized commute sometime between May 12-25, please register by answering the short survey below. Thank you.

Register by answering this survey by May 18, or register at a Keweenaw Bike to Work Day snack station in Calumet, Lake Linden, Hancock or Houghton during your morning or evening commute on May 18, to be entered in a drawing for prizes donated by local businesses.

Your name will be used for the raffle only. If you don't wish to give your name, you may still complete other questions to help us get an accurate count of participants. Your address may be used for bike route planning purposes. If you would rather not divulge your address, please consider giving the name of your street or a nearby location. Your email address may be used only with your permission to contact you about cycling and pedestrian issues. You are not required to give your phone number or email.

None of your personal information will be shared for ANY reason, except if you allow agents of the Houghton Bike/Pedestrian Committee or Western U.P. Health Department to contact you about pedestrian and cycling advocacy and planning issues, or about the prize drawing.

1. Please complete some or all of the information in this question. We require your name and either phone number or email in order to enter you in the prize drawing

Please complete some or all of the information in this question. We require your name and either phone number or email in order to enter you in the prize drawing Name:
Address:
Address 2:
City/Town:
ZIP:
Email Address:
Phone Number:

2. Please supply information about where you will commute on KB2WD.

Please supply information about where you will commute on KB2WD. Destination Name (of the worksite, school or other location)
Destination Location (Street, Town)
Length of Roundtrip in Miles (Estimate how far you will bike or walk)
Total Non-Motorized Miles for the Day (for commuting and recreation)

3. Which non-motorized transportation method will you use?

Which non-motorized transportation method will you use? BIke

Walk

Other (please specify)

4. Is this your first non-motorized commute?

Is this your first non-motorized commute? Yes

5. In a typical week, May to October, how do you get to work or school? You may pick more than one answer.

In a typical week, May to October, how do you get to work or school? You may pick more than one answer. Drive alone

Car pool

Bus

Taxi

Walk

Bike

Motorcycle

Scooter

Other (please specify)

6. Estimate how many days in 2012 you will use non-motorized transportation (walk, bike, etc.) to commute to work, school or errands. We are not asking about recreational or exercise rides and walks. We are asking you to estimate the number of days you will use non-motorized means for commuting to some necessary destination.

Estimate how many days in 2012 you will use non-motorized transportation (walk, bike, etc.) to commute to work, school or errands. We are not asking about recreational or exercise rides and walks. We are asking you to estimate the number of days you will use non-motorized means for commuting to some necessary destination. 1-5 days

6-20 day

21-50 days

51-100 days

more than 100 days

7. Would you like to receive information (perhaps several times a year at most) about upcoming local events related to pedestrian and cycling issues, such as public hearings or speakers?

Would you like to receive information (perhaps several times a year at most) about upcoming local events related to pedestrian and cycling issues, such as public hearings or speakers? Yes, please add me to your email list

Please don't contact me, unless I win a prize

Do not contact me for any reason

8. Would you like to be contacted by email before May 18 and matched with another person interested biking together along the same route?

Would you like to be contacted by email before May 18 and matched with another person interested biking together along the same route? Yes, I am an experienced bike commuter and would enjoy the company (be sure to give your email)

Yes, I am new to bike commuting and would enjoy the company (be sure to give your email)

No, I do not wish to be contacted to bike with someone else

KB2WD2012Exit this survey

KB2WD2012
Exit this survey