Lesson 7: Calculate Your Contribution



	Lesson 7: Calculate Your Contribution

	Sample Survey

	The following survey was developed by the Maryland Department of Transportation for high school students attending the Governor’s Youth Summit.

	To understand you better, and offer some interesting facts and insight for the upcoming 3rd Annual Governor’s Environmental Youth Summit we have developed this survey to collect information that will identify travel patterns. You do not need to identify yourself. Thank you for taking the time to complete the survey and returning it to the address listed. Your assistance is greatly appreciated.

	1. How many vehicles does your immediate family currently have?

	____None ____One ____Two ____ Three or more ____Other (Please specify.) ______________________________________
	2. How far do you live from school? (in miles)

	__________________________________________________________ Nearest major intersection (Please name both streets.) __________________________________________________________ City State Zip Code
	3. How do you get to school most days?

	____Bus ____Walk ____Ride bike ____Drive own car ____Driven by parent or other ____Other (Please specify.)_______________________________________
	4. How do you travel for recreation?

	____Bus ____Walk ____Ride bike ____Drive own car ____Driven by parent or other ____Other (Please specify.)_______________________________________
	5. What type of vehicles does your family drive?

	____Auto ____Pick Up Truck, SUV or Mini Van ____Motorcycle ____Bus ____Recreational Vehicle ____Single Unit Truck ____Multi-Unit Truck
	6. Including yourself, when going to school how many people are typically in the vehicle?____________

	7. Including yourself, when recreating (going to friends, the mall, etc.) how many people are typically in the vehicle?____________



	This section of the Survey is intended to gain an understanding about the transportation choices available to you where you live.

	1. Generally speaking, how would you classify the area in which you live?

	____Urban ____Suburban ____Rural ____Other (Please specify.) ______________________________________
	2. Are there sidewalks that you can use in your area? If not, is there so much traffic - or traffic that speeds - that inhibits your use of the road for walking or biking?

	____Yes ____No ____If "No" please specify: ______________________________________
	3. Does public transit service exist in your area? (Bus, light rail, Metro, MARC)?

	____Yes ____No If Yes, continue on to question 4, If No, go to question 6.
	4. Have you used public transit?

	____Yes ____No If Yes, continue to question 5, If No, go to question 6.
	5. How often? If not, why not?

	____Once in a while ____Once a month ____Once a week ____Every day ____Other (Please specify.)______________________________________
	6. How often do you drive in a car (either as a driver or passenger)?

	____Every day ____Once a month ____Once a week ____ Once in a while Other (please specify) ___________________________________________ Additional Comments? ___________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Control Number: ______________


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	© 2001 by Office of Social Studies, Anne Arundel County Public Schools, Annapolis, Maryland.
	Adapted with permission.