2016 Subsidized Bus Ticket Program Survey Please note: Any information provided using this form constitutes a public record and may be subject to public disclosure.Thank you for taking time to provide feedback about this program! Question Title * 1. Contact information Name Agency Name Email Address The following two questions refer to 2016 Question Title * 2. Amount requested (in dollars) Question Title * 3. Amount awarded (in dollars) The following two questions refer to 2015 Question Title * 4. Amount requested (in dollars) Question Title * 5. Amount awarded (in dollars) Question Title * 6. Years your agency was allocated bus tickets (check all that apply) 2010 2011 2012 2013 2014 2015 2016 How many clients do you anticipate serving with bus tickets: Question Title * 7. This year Question Title * 8. This month Question Title * 9. How does the bus ticket program complement your other services? Question Title * 10. Do you anticipate exhausting your supply of tickets before the end of the year? Yes No If you answered No, please move to Question No. 14. If you answered Yes, please respond to the following questions: Question Title * 11. In which month do you anticipate running out? January February March April May June July August September October November December Question Title * 12. How many more tickets could your organization use this year? Question Title * 13. If this number of additional tickets were available, would your organization have sufficient resources to pay the 20% of ticket value match? Yes No Question Title * 14. What is your experience with the program’s current compliance and reporting requirements? Question Title * 15. What is your organization’s overall experience using the program? Is the program easy to access and use? Question Title * 16. If you could make any changes to the program, what would you change? Done