What is the grade of the child for whom you are completing this survey? (K-8)

K
1
2
3
4
5
6
7
8

Is the child you are completing this survey for male or female?

Male
Female

How many children do you have in Kindergarten through 8th grade?

1
2
3
4
5
6
7
8

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

How far does your child live from school?

Less than 1/4 mile
1/4 mile up to 1/2 mile
1/2 mile up to 1 mile
1 mile up to 2 miles
More than 2 miles
Don't know

On most days, how does your child arrive at school and leave for home after school?

	Arrive at School	Leave for Home	Not Applicable
Walk
Bike
School Bus
Family vehicle (only with children from your family)
Carpool (riding with children from other families)
Transit (city bus, subway, etc.)
Other (skateboard, scooter, inline skates, etc.)

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

Yes
No

At what grade would you allow your child to walk or bike without an adult to/from school?

I would not feel comfortable at any grade
K
1
2
3
4
5
6
7
8

Which of the following issues affected your decision to allow, or not allow, your child to walk or bike to/from school? (check all that apply)

Distance
Convenience of driving
Time
Child's before or after school activities
Speed of traffic along route
Amount of traffic along route
Adults to walk or bike with
Sidewalks or pathways
Safety of intersections and crossings
Crossing guards
Violence or crime
Weather or climate

Does your child already walk/bike to school?

Yes
No

Would you probably let your child walk or bike to/from school if this problem were changed or improved

	Yes	No	Not Sure
Distance
Convenience of driving
Time
Child's before or after school activities
Speed of traffic along route
Amount of traffic along route
Adults to walk or bike with
Sidewalks or pathways
Safety of intersections and crossings
Crossing guards
Violence or crime
Weather or climate

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

Strongly encourage
Encourage
Neither
Discourage
Discourage

How much FUN is walking or biking to/from school for your child?

Very Fun
Fun
Neutral
Boring
Very Boring

How HEALTHY is walking or biking to/from school for your child?

Very Healthy
Healthy
Neutral
Unhealthy
Very Unhealthy

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

Grades 1-8 (Elementary)
Grades 9-11 (Some high school)
Grade 12 or GED (High school graduate)
College 1-3 years (Some college or technical school)
College 4 years or more (College graduate)
Prefer not to answer

Please provide any additional comments below:

Commuting to School Parent Questionnaire