* 1. In which jurisdiction do you live?

* 2. Identify your age group

* 3. What’s the average number of days per week that you drive?

* 4. Which of the following topics are of most interest to you?

* 5. What do you plan to do with the Resource Guide?

* 6. How important is it for you to have this Resource Guide in print – rather than online?

* 7. Please provide your phone number or email to contact you in a few months for a brief follow-up survey. Your private contact information will only be used for this specific purpose and won’t be shared with others.

* 8. Online, or if paper survey, what organization and/or event survey was completed?

* 9. Date survey completed

Date / Time