Hollister SRTS Survey Fall 2013

Hello,
Your child's school wants to learn your thoughts about children walking and biking to school. This survey will take about 5-10 minutes to complete. We ask that each family complete only one survey per school your children attend. If more than one child from a school brings a survey home, please fill out the survey for the child with the next birthday from today's date.

Your responses will be kept confidential and neither your name nor your child's name will be associated with any results.

Thank you for participating in this survey!

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* 1. School name

Calaveras

RO Hardin

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* 2. What is the grade of the child who brought home this survey?

Preschool

Kindergarden

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* 3. Is the child who brought home this survey male or female?

Male

Female

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* 4. How many children do you have in Kindergarten through 8th grade?

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* 5. What is the street intersection nearest your home?

First intersecting street

Second intersecting street

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* 6. How far does your child live from school?

Less than 1/4 mile

1/4 mile up to 1/2 mile

1/2 mile up to 1 mile

1 mile up to 2 miles

More than 2 miles

Don't know

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* 7. On most days, how did your child arrive and leave for school? (Select one choice per row)

	Walk	Bike	School bus	Family vehicle (only children in your family)	Carpool (with children from other families)	Transit (city bus, subway, etc.)	Other (skateboard, scooter, inline skates, etc.)
Arrive at school	Arrive at school Walk	Arrive at school Bike	Arrive at school School bus	Arrive at school Family vehicle (only children in your family)	Arrive at school Carpool (with children from other families)	Arrive at school Transit (city bus, subway, etc.)	Arrive at school Other (skateboard, scooter, inline skates, etc.)
Leave from school	Leave from school Walk	Leave from school Bike	Leave from school School bus	Leave from school Family vehicle (only children in your family)	Leave from school Carpool (with children from other families)	Leave from school Transit (city bus, subway, etc.)	Leave from school Other (skateboard, scooter, inline skates, etc.)

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* 8. How long does it normally take your child to get to/from school? (Select one choice per row)

	Less than 5 minutes	5 - 10 minutes	11 - 20 minutes	More than 20 minutes	Don't know/Not sure
Travel time to school	Travel time to school Less than 5 minutes	Travel time to school 5 - 10 minutes	Travel time to school 11 - 20 minutes	Travel time to school More than 20 minutes	Travel time to school Don't know/Not sure
Travel time from school	Travel time from school Less than 5 minutes	Travel time from school 5 - 10 minutes	Travel time from school 11 - 20 minutes	Travel time from school More than 20 minutes	Travel time from school Don't know/Not sure