Draft New Visions 2050 Plan Survey Question Title * 1. What town/city/village do you live in?: ____________________________________________ Question Title * 2. Are you satisfied with the quality of the Capital Region’s transportation system? Yes No No opinion Question Title * 3. Are you satisfied with the transportation choices available to you and your community? Yes No No opinion Question Title * 4. Age: Under 18 25-34 35-44 45-54 55-64 Over 65 Prefer not to say Question Title * 5. What is your Gender? Male Female Other Prefer Not to Say Question Title * 6. What is your ethnicity? White Hispanic or Latino Black or African American Native American or American Indian Asia/Pacific Islander Other Question Title * 7. Do you have a disability? Yes No Prefer not to say Question Title * 8. Do any of these describe you? Please check all that apply: Low-income Zero Vehicle Household Minority Limited English Business-owner operating in Albany, Rensselaer, Saratoga, and/or Schenectady counties Question Title * 9. What modes do you use to commute to work? Check all that apply: Drive Alone Carpool Bus Bike Walk Telecommute •Other Question Title * 10. What modes do you use for other types of trips? Check all that apply: Drive Alone Carpool Bus Bike Walk Telecommute Other Question Title * 11. Are there modes or services currently not available to you for commute and non-commute trips that you hope become available? Check all that apply: Drive Alone Carpool Bus Bike Walk Telecommute Other Question Title * 12. Additional comments about New Visions 2050: Question Title * 13. Would you like to receive Newsletters and other updates on transportation planning and projects in the Capital Region? We can add you to our mailing list: Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Done
