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OCR for page 102
102
APPENDIX A
Subject Data Collection Forms
Circle the letter grade that most represents your perceived service.
A = highest rating F = lowest rating
Please view the entire video clip before selecting a rating.
Pedestrian Presentation
Clip Number Perceived Service Rating
Practice Clip #212 A B C D E F
#201 A B C D E F
#226 A B C D E F
#225 A B C D E F
#208 A B C D E F
#219 A B C D E F
#228 A B C D E F
#211 A B C D E F
#215 A B C D E F
#229 A B C D E F
#222 A B C D E F
OCR for page 103
103
Circle the letter grade that most represents your perceived service.
A = highest rating F = lowest rating
Please view the entire video clip before selecting a rating.
Bicycle Presentation
Clip Number Perceived Service Rating
Practice Clip #326 A B C D E F
#319 A B C D E F
#308 A B C D E F
#306 A B C D E F
#309 A B C D E F
#320 A B C D E F
#318 A B C D E F
#304 A B C D E F
#324 A B C D E F
#321 A B C D E F
#329 A B C D E F
Circle the letter grade that most represents your perceived service.
A = highest rating F = lowest rating
Please view the entire video clip before selecting a rating.
Automobile Presentation
Clip Number Perceived Service Rating
Practice Clip #5 A B C D E F
#20 A B C D E F
#56 A B C D E F
#10 A B C D E F
#51 A B C D E F
#14 A B C D E F
#2 A B C D E F
#62 A B C D E F
#63 A B C D E F
#52 A B C D E F
#15 A B C D E F
OCR for page 104
104
Please circle the choice which best describes your characteristics.
1. Your age group: 18-35 years of age 36-60 years of age 60 and up years of age 2. Gender: Male Female
3. Number of vehicles in your household: 0 1 2 3 or more 4. Number of bicycles in your household: 0 1 2 3 or more
5. Employment status: Employed Unemployed Homemaker Retired
6. Your primary residence is: A. Single-family detached home B. Apartment/duplex/townhouse/condominium
C. Group quarters such as a college dormitory or independent living facility D. Other, please specify: ________________
7. Do you rent or own your home? A. Rent B. Own 8. What is your primary residence/home zip code? ______________
9. If you are currently employed, what is your workplace zip code (or city of location): __________________________
10. How often do you walk more than two blocks a week for a non-recreational trip (for example, walk to work, walk to school, walk to a store)?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
11. How often do you walk more than two blocks a week for a recreational trip or for exercise ?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
12. How often do you use a bicycle for a non-recreational trip (for example, ride a bike to work, ride a bike to a store)?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
13. How often do you use a bicycle outside of a gym for a recreational trip or for exercise ?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
14. How often do you use transit (bus, subway, train)?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
15. How often do you use a car?
A. Never B. Less than once a month C. About once a week D. More than once a week but not every day E. At least once a day
16..What is your usual means of travel to work? A. Auto, drive alone B. Auto, carpool C. Transit (bus, train, ferry or other) D. Walk
E. Bike F. Other: ________________________