“2012 New Madrid Incident Management Peer Exchange” Pre-Event Participant Survey

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* 1. Type of Participant/Stakeholder:

A.) Federal Govt. Partner

(B.) State Govt. Partner

(C.) Local Govt. partner

(D.) Private Industry Partner

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* 2. Name, email contact information.

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* 3. What is your Discipline?

(A.) Road-Passenger

(B.) Road-Freight

(C.) Rail-Freight

(D.) Rail-Passenger

(F.) Air-Freight

(G.) Air-Passenger

(H.) Maritime

(I.) Pipeline-“Hazardous Liquids and Gas”

(J.) Federal Govt. Partner

(K.) State Govt. Partner

(L.) Local Govt. Partner

Other (please specify)

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* 4. Training/Track Product?

(A.) Lessons Learned

(B.) Scenario Based

(C.) Regulatory

(D.) Q &A-Regulatory vs. Participants

(H.) Panel Discussion

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* 5. Meals to be included in cost of registration

(A.) yes

(B.) no

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* 6. Cost of Registration with meals?

(A.) $135.00

(B.) $150.00

(C.) $175.00

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* 7. Cost of Registration without meals, but with snacks provided at breaks?

(A.) $75.00

(B.) $85.00

(C.) $100.00

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* 8. General cost of overnight room cost, tax excluded?

(A.) $75.00

(B.) $85.00

(C.) $99.00

(D.) $105.00

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* 9. Would you be interested in being a participant of this First National Event for Transportation Stakeholders Peer Exchange?

(A.) yes

(B.) no