Welcome to the Go Chapel Hill Birthday Club - Building a Healthier Community Together! Thank you!

Birthday Club 2021

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* 1. Number of days in the next 12 months that I will use these commute modes including telework:

	5 days	12 days	Daily	Twice Monthly	1-3 days
Bicycle	Bicycle 5 days	Bicycle 12 days	Bicycle Daily	Bicycle Twice Monthly	Bicycle 1-3 days
Carpool	Carpool 5 days	Carpool 12 days	Carpool Daily	Carpool Twice Monthly	Carpool 1-3 days
Park & Ride with Transit	Park & Ride with Transit 5 days	Park & Ride with Transit 12 days	Park & Ride with Transit Daily	Park & Ride with Transit Twice Monthly	Park & Ride with Transit 1-3 days
Telework	Telework 5 days	Telework 12 days	Telework Daily	Telework Twice Monthly	Telework 1-3 days
Transit	Transit 5 days	Transit 12 days	Transit Daily	Transit Twice Monthly	Transit 1-3 days
Vanpool	Vanpool 5 days	Vanpool 12 days	Vanpool Daily	Vanpool Twice Monthly	Vanpool 1-3 days
Walk	Walk 5 days	Walk 12 days	Walk Daily	Walk Twice Monthly	Walk 1-3 days

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* 2. Number of miles to the building I work in, if not working from home:

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* 3. How many days did you use alternative transportation (including telework) in the past 12 months:

2-4 days

12 days

Twice Monthly

Most work days

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* 4. I work from home most of the time.

Yes

No

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* 5. Name:

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* 6. Name of Department and company, business, or agency where I work:

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* 7. My E-Mail Is:

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* 8. Optional- Tell Your Story: Please add my commute story, for promotions, to inspire others to try leaving their car at home (at least sometimes).

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* 9. Yes please send Happy Birthday Go Chapel Hill item to me! Address follows.