1.Name (First and Last)

2.Please share your email address

3.Age

Under 18

18-24

25-34

35-44

45-54

55-64

65+

4.What is your gender identity?

Woman

Man

Genderqueer or non-binary

Agender

Not specified above, please specify

5.What county do you live in?

6.Zip Code

7.What is your ethnicity? (select all that apply.)

American Indian or Alaskan Native

Asian or Pacific Islander

Black, African or African American

Hispanic, Latino/a, or of Spanish origin

White / Caucasian

Prefer not to answer

Other (please specify)

8.How did you hear about this opportunity? ( organization or individual name)

9.Have you done any of the following?

Completed 50+ miles on the Towpath Trail

Traveled for a distance cycling ride

Completed a multi-day cycling trip

None of the Above

Completed a multi-day ride on the Towpath Trail

10.How often do you cycle? (daily, weekly, monthly, a few times a year, etc.)

11.What distance do you usually cycle? (<5 miles, 5-10 miles, 10-20 miles, 50 miles, etc.)

12.Are you available to attend an in-person evening discussion group the week of June 2-6?

Yes

No

Unsure