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* 1. This information will be held by Bristol City Council to help deliver this project. The Privacy Notice for this project can be found at: https://travelwest.info/pages/privacy-policy/roadshow-team-privacy-policy

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* 2. Please click which offers you are interested in receiving

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* 3. What else would encourage you to choose make walking, cycling and public transport for more of your everyday journeys? 

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* 4. If you have requested a loan bike, please provide your height in feet and inches.

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* 5. Your name

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* 6. Email

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* 7. Contact number

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* 8. Address

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* 9. Post code

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* 10. Number of adults in the household (17+):

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* 11. Number of children in household

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* 12. Number of bikes in the household

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* 13. Number of cars in the household

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* 14. How many people hold a licence in your household

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* 15. Normally, how often do you travel by the following types of transport? (Please exclude half term and bank holiday weeks)

  6-7 days per week 4-5 days per week 2 to 3 days per week Once a week Once a month Less frequent/ Never
Walk
Cycle
Bus
Motorcycle or scooter
Train
Car driver (alone)
Car driver (with others)
Car passenger
Other

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* 16. How do you normally travel to the following places?

  Work Education Shopping/Erands Health (e.g. Doctor) Leisure
Walk
Cycle
Bus
Motorcycle or scooter
Train
Car driver (alone)
Car driver (with others)
Car passenger
Other

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* 17. Who is your local authority?

0 of 17 answered
 

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