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TIBURON TRANSIT ASSESSMENT SURVEY

 

1. Please specify your gender (optional):

Please specify your gender (optional):   Male

Female

2. Please indicate your age (optional):

Under 1818-2425-3435-4445-5455-6464 or olderPrefer not to say

Please indicate your age (optional):

3. What is the nearest cross street to your residence?

What is the nearest cross street to your residence?   First Street:
Second Street:

4. What is your zip code?

What is your zip code?   Zip Code:

5. Please identify your race or ethnicity (optional):

Please identify your race or ethnicity (optional):   African American Caucasian/White Hispanic	Asian or Pacific Islander Native American
Other (please specify):

6. Please state your annual household income (optional):

Please state your annual household income (optional):   Less than $25,000 $25,000-$49,999 $50,000-$74,999

$75,000-$99,999 $100,000-$149,999 $150,000 or more

7. Do you have access to a personal vehicle?

Do you have access to a personal vehicle?   Yes No

8. Please tell us about your typical travel needs and mode of choice (please select all that apply):

	Work	Shop	Recreation	Medical	School
Tiburon	DriveRideTransitBikeWalk Please tell us about your typical travel needs and mode of choice (please select all that apply):   Tiburon   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Belvedere	DriveRideTransitBikeWalk Belvedere   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Strawberry Village	DriveRideTransitBikeWalk Strawberry Village   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
South Marin	DriveRideTransitBikeWalk South Marin   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Mill Valley	DriveRideTransitBikeWalk Mill Valley   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Sausalito	DriveRideTransitBikeWalk Sausalito   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
San Rafael	DriveRideTransitBikeWalk San Rafael   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Ross Valley (Fairfax, San Anselmo, Ross, Kentfield)	DriveRideTransitBikeWalk Ross Valley (Fairfax, San Anselmo, Ross, Kentfield)   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Larkspur/Corte Madera	DriveRideTransitBikeWalk Larkspur/Corte Madera   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Northern Marin (including Novato)	DriveRideTransitBikeWalk Northern Marin (including Novato)   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
San Francisco	DriveRideTransitBikeWalk San Francisco   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
East Bay (Oakland, Berkeley, etc.)	DriveRideTransitBikeWalk East Bay (Oakland, Berkeley, etc.)   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
West Marin	DriveRideTransitBikeWalk West Marin   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School
Other (specify below)	DriveRideTransitBikeWalk Other (specify below)   Work	DriveRideTransitBikeWalk Shop	DriveRideTransitBikeWalk Recreation	DriveRideTransitBikeWalk Medical	DriveRideTransitBikeWalk School

Please specify other locations:

*

9. Do you typically use the bus for any of your travel?

Do you typically use the bus for any of your travel?   Yes No