1. How long have you lived at this address? years
2. Is your home owned or rented?Owned
Provided by Job or Military
Other [Specify] _______________
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
5. What is your age? years
6. Are you:Male
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)
Graduate or Professional degree
9. What is your marital status?Never married
10. During most of last week, were you...Working
Temporarily absent from a job or business
Looking for work
Going to school
11. Last week, did you do any work for either pay or profit?Yes
12. Do you work... (You may give more than one answer)Full Time
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
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
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?
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
Rail (Metro, commuter rail, etc.)
Pedicab / Auto rickshaw
App-based ride (Uber / Lyft or similar)
Other [Specify] ________________________________________
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]
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
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
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