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Survey/Feedback Form

Please Take two minutes to complete our on-line survey. All information is kept strictly confidential and used only to measure the success of this program.

Your Information

First Name*
Last Name*
Age
Gender
Street Address*
City*
Province
Postal Code
Phone*
Email*

Must be an valid email address


Your Carpooling Information

Destination/Work-Site (ie: Name of Employer):
Average Daily Commute Distance (To and From in KM):
Average Daily Commute Time (in minutes):
Usual/previous method of commuting:
Type of Car Driven:
Please describe your carpool habits by selecting one of the options below*:






Please rate the following incentives that could be used to encourage more carpooling.
Please use a scale of 1-5, with 1 identifying the strongest incentive and 5 identifying the weakest incentive:

HOV Lanes(High Occupancy Vehicle or Express Lanes) to allow carpools to travel faster through traffic:
Reserved/Designated Parking for Carpools:
Discounted Parking for Carpools:
Emergency Ride Home Program (taxi vouchers to be used on a limited basis to get carpoolers home in an emergency):
Rewards Program (gifts and discounts for carpoolers):
Would you be interested in becoming involved in a group to advocate for carpool rights and benefits?
Which statement below describes the strongest motivation you have for wanting to carpool?





Other Information

Please rate the following aspect of the https://www.carpool.ca program (from 1 to 5 with 1 being the lowest and 5 being the highest).

User-Friendliness
Web Design
Sufficient Relevant Information
Easy to Find

How did you hear about this program?

Employer/Post-Secondary Institution Referral
Media
Internet Search Engines
Word of Mouth
Promotional Materials (posters etc)
Road Sign
Information Session/Transportation Fair
Parkade Promotion/Referral
Other
Social Media (Facebook, Twitter, etc)
Any other comments you would like to add: