* 1. Name

* 2. Employer 

* 3. Employer Location (city)

* 4. Home Location (city)

* 5. Do you plan to ride your bike to work during Bike to Work Week (May 14- May 18)?

* 6. During a regular month, how often do you commute by bicycle? 

* 7. About how long is your bike route from home to work (miles)?

* 8. What is your main reason for biking in Ventura County? 

* 9. How do you feel your experience as a bicycle commuter could be improved? Please rank below, 1 being the most important.

* 10. What is the biggest impediment to biking to work?

* 11. Please provide any additional feedback not covered by the questions above.

* 12. Would you like to receive additional information from VCTC about biking and other transportation topics?

* 13. If yes, please provide your email address.

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