MSS - Walking to School
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1
. What grade are you in?
What grade are you in?
Fourth
Fifth
Sixth
2
. Are you male or female?
Are you male or female?
Male
Female
3
. Do you walk, bike, scooter, skateboard, take the bus, or ride with parents to school?
Do you walk, bike, scooter, skateboard, take the bus, or ride with parents to school?
Walk
Bike
Scooter
Skateboard
Bus
Parents/Guardians
4
. How often do you walk or ride (bike, scooter, skateboard etc.) to school?
How often do you walk or ride (bike, scooter, skateboard etc.) to school?
Weekly or more often
Monthly or less often
Other
5
. How far do you live from school?
How far do you live from school?
0-1 miles
1-2 miles
2-5 miles
Greater than 5 miles
6
. If you don't walk or ride to school, would your parents/guardians let you if you wanted to?
If you don't walk or ride to school, would your parents/guardians let you if you wanted to?
Yes
No
7
. If your parents/guardians don't let you walk, how come? Please explain below:
If your parents/guardians don't let you walk, how come? Please explain below:
8
. What could the school do to encourage you to walk or ride (bike, scooter, skateboard) etc.?
What could the school do to encourage you to walk or ride (bike, scooter, skateboard) etc.?
9
. What season do you walk the most?
What season do you walk the most?
Fall
Winter
Spring
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