Demographic Data

1. How long have you lived at this address?

years

2. Is your home owned or rented?

Owned
Rented
Provided by Job or Military
Other [Specify] _______________
Don't Know

3. Including yourself, how many people live in your household? Please do not include anyone who usually lives somewhere else or is just visiting, such as a college student away at school.

people

4. Are any of these people related to each other?

Yes
No
Don't Know

5. What is your age?

years

6. Are you:

Male
Female
Other

7. How would you describe your ethnicity or race?

8. Education: Years of school completed.

Less than high school/secondary school
Completed high school/secondary school (or equivalent certification)
Vocational training (beyond high school/secondary school)
Some university/college (less than 4 years)
College/University degree
Graduate or Professional degree
Don't Know

9. What is your marital status?

Never married
Married
Separated
Divorced
Widowed
Don't know

10. During most of last week, were you...

Working
Temporarily absent from a job or business
Looking for work
Homemaker
Going to school
Retired
Other _______________________
Don't Know

11. Last week, did you do any work for either pay or profit?

Yes
No
Don't Know

12. Do you work... (You may give more than one answer)

Full Time
Part-time
Multiple Jobs
Don't Know

13. Of these four categories of occupations, please tell me which one your primary job falls under.

Sales or service
Clerical or administrative support
Manufacturing, construction, maintenance, or farming
Professional, managerial, or technical
Other (Specify)________________________
Don't Know

14. Not including getting to and from work, do you work at any job that requires you to drive a licensed motor vehicle as part of the job?

Yes
No
Don't Know

15. If you answered yes to the previous question: What is that job or occupation?

16. What is the street address of your primary workplace?

17. If you don't know: Would you please provide a landmark that is close to your workplace? This could be a well-known building, park, monument, or school.

18. What is the one-way distance from your home to your primary workplace?

miles

19. How many minutes did it usually take you to get from home to work last week?

minutes

20. How did you usually get to work last week? (You may pick more than one)

Automobile
Public bus
Rail (Metro, commuter rail, etc.)
Bicycle
Walk
Pedicab / Auto rickshaw
Taxicab
App-based ride (Uber / Lyft or similar)
Other [Specify] ________________________________________
Don't Know

21. On any day in the past two months, did you work from home instead of traveling to your usual workplace?

Yes [Worked At Home INSTEAD of at Work]
No [Never Worked Solely From Home]
Don't Know

22. If you do work from home, about how often do you do this?

Almost Every Day
Once a Week or More
Once a Month or More
A Few Times a Year
Once a year
Don't Know

23. How many vehicles are owned, leased, or made available for regular use by the people who live in your household? Be sure to include motorcycles, mopeds, RVs and any vehicle that is company-owned.

vehicles

24. How many adult-size bicycles (any bike large enough for an adult) does your household have in working order?

bicycles

We would like to ask you some questions regarding your experience of biking in your neighborhood. But first, we need to establish whether you have ever biked in your neighborhood.

25. Have you ridden a bicycle in your neighborhood in the past 2 years?

Yes
No
Don't Know

26. Please recall the most recent time you rode your bicycle in your neighborhood. When was that?

Within the past day
Within the past week
Within the past month
Within the past year
Within the past 2 years

Household Income: In surveys like these, households are sometimes grouped according to income. Please stop me when I get to the category that best describes your total household income, before taxes, in the past 12 months.

27. Approximate annual household income