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Sample Employee Survey for Metrochek
TO: All Employees
FROM: High-level Official at COMPANY ABC
SUBJECT: Commute Survey
COMPANY ABC is considering offering a tax-free transit benefit to all employees who commute from home to work on public transportation and vanpools. We are working with Arlington Transportation Partners (ATP) to assess commuting patterns and preferences. Please complete the following questions regarding your commute and return the survey to COMPANY ABC's staff person by specific date.
- What is the primary mode of transportation used in your commute to work?
If more than one mode, check only the final mode you used to reach your worksite. Do not check "walked" if you walked to or from your car, bus, train station, etc.
__Walked (as my only mode from home to work)
__Drove alone (including motorcycle/moped)
__Carpool (including being dropped off)
Including yourself, how many persons were in the carpool?
Were you: __driver __passenger
__Vanpool (including being dropped off)
Including yourself, how many persons were in the vanpool?
Were you: __driver __passenger
__Bus, Metrorail, Amtrak, MARC and /or VRE (includes drive, walk or shuttle to bus stop, station, or park and ride lot) Is Metrorail your main travel method to work? _ yes _ no
__Bicycle (as my only mode from home to work)
__Casual Carpool/Slug (I was picked up by someone with whom I do not have a regular carpool arrangement).
- On average, how many days per month do you use public transportation (including vanpools) in your direct commute to work?
- On average, how much do you spend per month using public transportation (including vanpools) in your direct commute to work? (Exclude any parking charges at park and ride lots, transit stations, vanpool staging areas, or other parking lots. Do not include costs for additional stops such as dependent care facilities, shopping, errands, etc.): $______
- If you drive to a public transit station, a park and ride lot, or to a vanpool staging area, how much, on average, do you spend on parking at these facilities each month? $______
- How likely would you be to use public transportation or a vanpool if COMPANY ABC offered a tax-free transit benefit??
__Very likely __Somewhat likely __Not likely
- How far do you live from your worksite (in miles)?
__0-9 __10-19 __20-29 __30-39 __40-49 __50 or more
DO NOT answer question 7 if you regularly use transit, carpool, vanpool, bicycle or walk to work.
- If you usually drive alone to work, would you switch to an alternative commute mode (i.e. transit, carpool, vanpool, bicycle) if you were offered the following:
a. A guaranteed ride home in an emergency __Yes __No
b. Flextime __Yes __No
c. A monthly transit benefit __Yes __No
d. A monthly vanpool benefit __Yes __No
e. Free parking for carpool/vanpool __Yes __No
f. Free assistance to find carpool or vanpool __Yes __No
g. Transit route & schedule information __Yes __No
h. Bicycle storage/shower facilities __Yes __No
Comments regarding your commute to work:
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