Please fill out a form for each person in a household. Thank You
Name:
(for prize draw only)
Address:
*
Postal Code:
* (V1T 5E6)
Gender:
Male or
Female
Age:
1. How many of these vehicles do you own?
Car/Truck:
Motor Bike:
Road Bicycle:
Mountain Bike:
2. How would you class yourself as a cyclist?
Experienced / Confident:
Competent but don't like busy roads:
Returning to cycling:
Beginner:
3. In an average week, how many of these trips do you make by motor vehicle (inclue taxis or other people's vehicles)?
To / From Work:
To / From School or College:
To Shops:
Get to a leisure activity:
4. In an average week, how many of these trips does each person make by bike?
To Work:
To / From School or College:
To Shops:
As a leisure activity or to get to one:
5. Where does each person mostly cycle?
On road bike lanes:
Off road / multi-use paths:
Streets with not much traffic:
6. In an average week, how many of these trips does each person make by walking?
To Work:
To school or college:
To Shops:
As a leisure activity or to get to one:
7. In an average week, how many trips does each person make by bus (including HandyDart)?
To Work:
To school or college:
To Shops:
To get to a leisure activity:
