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Parent Survey

  1. 4. What is the street intersection nearest your home? (provide the names of two intersecting streets)

  2. and

  3. 5. How far does your child live from school?

  4. 6. On most days, how does your child arrive at school?

  5. 7. How long does it normally take your child to get to school?

  6. 8. Has your child asked you for permission to walk or bike to/from school in the last year?

  7. I would not feel comfortable at any grade

  8. 10. Which of the following issues affected your decision to allow, or not allow, your child to walk or bike to/from school?

  9. Distance

  10. Child's before or after-school activities

  11. Convenience of Driving

  12. Speed of traffic along route

  13. Time

  14. Amount of traffic along route

  15. Adults to walk or bike with

  16. Sidewalks or pathways

  17. Safety of intersections and crossings

  18. Crossing Guards

  19. Violence or crimes

  20. Weather or climate

  21. In your opinion, how much does your child's school encourage or discourage walking and biking to/from school?

  22. How much fun is walking or biking to/from school for your child?

  23. How healthy is walking or biking to/from school for your child?

  24. What is the highest grade or year of school you completed?

  25. Leave This Blank:

  26. This field is not part of the form submission.