Regional Planning Email List Question Title * 1. Your Contact Information First Name Last Name Organization or Affiliation Home Zip Code Question Title * 2. Valid Email Address Question Title * 3. In which of the following topics are you interested? Aging and Disability Issues Economic Development Trends Environmental Quality Freight and Goods Movement General news and updates on transportation planning Housing Affordability Land Use and Urban Design Proposed Transportation Improvements Public Funding and Financing Public Meetings and Events Public Transit Issues Real Estate Development Trends Regional Policy and Decision-making Roadway Construction Roadway Safety Issues Rural Issues Social Equity and Inclusion Upcoming Planning Activities and Studies Walking & Bicycling Issues Other (please specify) Question Title * 4. In which ways are you interested in being involved in regional planning efforts? I am interested in taking surveys I am interested in participating in a small focus group discussion I am interested in attending public meetings and workshops I am interested in having a formal role on a taskforce or committee I am interested in sharing my opinion through social media platforms like Facebook, Twitter, and Instagram I am interested in reviewing draft documents prior to formal adoption Other (please specify) Question Title * 5. What is your gender? Female Male Other (please specify) Question Title * 6. What is your age? 17 or younger 18-20 21-29 30-39 40-49 50-59 60 or older Question Title * 7. With which races or ethnicity groups do you identify? White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Other (please specify) Question Title * 8. Which of the following categories best describes your employment status? Employed, working full-time Employed, working part-time Not employed, looking for work Not employed, NOT looking for work Retired Disabled, not able to work Question Title * 9. How many people currently live in your household? (include adults and children) 1 2 3 4 5 6 7 8 9 10 or more Question Title * 10. How many children, age 17 or younger, currently live in your household? None 1 2 3 4 5 6 7 8 9 10 or more Question Title * 11. What is your approximate annual household income? Less than $25,000 $25,000-$49,999 $50,000-$74,999 $75,000-$99,999 $100,000-$149,999 $150,000-$199,999 $200,000 and up Question Title * 12. Please share any comments you have for us at this time. Done
