Welcome to the Way to Go Thank You Drawing sign up. Survey

You may sign up for this drawing if you live or work in Seattle.

Please submit only one entry per person per quarter.

1

*Please provide your contact information:

Please provide your contact information: First Name:
Last Name:
Home Street Address:
Home City:
Home Zip:
Phone:
Email:

Please provide some info on a specific trip within the last month where you traveled without driving alone.

2

	MM		DD		YYYY		HH		MM	AM/PM
Date of trip	Date of trip Month	/	Day	/	Year		Hour	:	Minute	AM or PM

3

*Method of travel:

Method of travel: Walk

Bike

Bus

Streetcar

Light rail

Commuter train

Carpool

Vanpool

Other, please specify

4

*Length of trip in miles (one way):

Length of trip in miles (one way):

5

How often do you usually take this trip without driving?

How often do you usually take this trip without driving? 1-3 times per month

1-3 times per week

4-5 times per week

6

How long have you taken this trip without driving?

How long have you taken this trip without driving? Less than 1 month

6 months

6- 12 months

1-2 years

3 or more years

7

Verifier

Please provide the name of someone who can verify that you travel by this method (such as a co-worker or a neighbor).

We appreciate you taking a little extra time to provide this info. This is one way we can confirm that the people receiving the prizes truly earned them.

Verifier Please provide the name of someone who can verify that you travel by this method (such as a co-worker or a neighbor). We appreciate you taking a little extra time to provide this info. This is one way we can confirm that the people receiving the prizes truly earned them. Verifier First Name:
Verifier Last Name:
Verifier Home Street Address:
Verifier Home City:
Verifier Home Zip:
Verifier Phone:

8

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Walk Bike Rider e-newsletter sign up

This free monthly resource is a quick read with relevant and timely tips, tools and inspiration to walk, bike and use transit.

Click here to see previous newsletters. You may unsubscribe any time.

If you do not respond to this question we will assume you wish to subscribe.

If you already subscribe, don't worry, we make sure that no one receives multiple copies in their inbox.

Yes. I would like to receive this e-newsletter.

No thank you.