Screen Reader Mode Icon
Pacoima Beautiful & Envoy are currently working to evaluate how many community members would be interested in using the upcoming shared electric vehicle (EV) program. If you are interested in participating please complete the following information.

Question Title

* 1. Today's Date

Question Title

* 2. Your Neighborhood

Question Title

* 3. First Name

Question Title

* 4. Last Name 

Question Title

* 5. Email Address

Question Title

* 6. Age (please enter in whole numbers)

Question Title

* 7. Would you like to participate in the Pacoima Community Electric Vehicle Car Sharing Pilot?
 

Question Title

* 8. Do you live in the city of Pacoima?

Question Title

* 9. What is your gender?

Question Title

* 10. Do you have a driver's license?

Question Title

* 11. Do you currently have a smart phone (that can download "apps?)"

Question Title

* 12. Do you currently own/lease a car?

Question Title

* 13. What days do you think would you most need the vehicle? (Mark all that apply)

Question Title

* 14. What time of day do you think would you most need the vehicle? (mark all that apply)

Question Title

* 15. Participants may be eligible for reduced pricing. Would you like to be considered for enrollment in the price reduction program?

Question Title

* 16. Would the Pacoima EV car sharing program be your first time driving an electric vehicle?

Question Title

* 17. What is your level of interest in EV car sharing?

Question Title

* 18. How familiar are you with EV car sharing?

Question Title

* 19. How many people live in your household?

Question Title

* 20. Where will you go using EV car sharing?

Question Title

* 21. Anything else we should know about to help design the community's EV car sharing? (Please send us your comments!)

0 of 21 answered
 

T