Privacy Notice:
Information provided in this survey is considered a public record and may be subject to public disclosure. For more information, see the Public Records Act, RCW Chapter 42.56. To learn more about how we manage your information, see our Privacy Statement.
If your workplace is in Othello or Rainier Beach, you can complete the following registration form to receive your free ORCA card. If you are eligible, we will mail a card to your workplace. Your information will not be shared and will be used for program evaluation and organization only. For more information and eligibility requirements, visit the ORCA Recovery Card Program webpage.

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* 1. What is your full name?

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* 2. What is your email? We may use this to contact you with information about the Recovery card.

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* 3. What is your phone number? We may use this to contact you with information about the Recovery card.

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* 4. Where do you work? (Write in the name of your workplace)

The following questions ask about your current travel habits. Your responses will help us understand the impact of the ORCA Recovery Card. Your responses to these questions will not impact your eligibility for the ORCA Recovery Card.

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* 5. How do you most often pay for transit?

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* 6. In a typical week, how often do you take public transit?

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* 7. Thinking about your current travel habits, please mark how much you agree with the following statements:

  Strongly agree Agree Neutral Disagree Strongly disagree
It is easy to travel to and from work
Public transit is affordable for me
I use public transit to get to work
I use public transit to get to non-work related areas of daily life (grocery stores, school, medical appointments, etc.
I use public transit to get to places of leisure (parks, to see friends and family, etc.)
Public transit is my preferred transportation option

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