Parent Survey: Walking and Biking to School

Question Title

* 1. School Name

Question Title

* 2. How many children do you have in Kindergarten through 8th Grade?

1 Male

2 Male

3 Male

4 Male

5+ Male

1 Female

2 Female

3 Female

4 Female

5+ Female

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* 3. In what grade is your child enrolled?

PK

K

1

2

3

4

5

6

7

8

Question Title

* 4. What is the street intersection nearest your home?

East/West Street Name

North/South Street Name

Question Title

* 5. How far is your home from school?

Less than 1/4 mile

1/4 to 1/2 mile

1/2 mile to 1 mile

1 mile to 2 miles

More than 2 miles

Don't know