Community Travel Survey 1. Which Cooee service are you interested in? Select a routeAldavilla PS, Yarravel with KempseyCrossmaglen PS with Coffs HarbourCoramba, Karangi PS with Coffs HarbourThrumster with Port MacquarieUpper Rollands Plains, Telegraph Point with Port Macquarie 2. Over the past month how often have you travelled to --insert city-- on a weekday? - Select -No travelOnce per monthOnce per fortnightOnce per week2-4 times per week 5-7 times per week 3. What was the main purpose for your travel to --insert city--? 3. What was the main purpose for your travel to --insert city--? - Select -ShoppingWorkEducationMedicalVisit family and friendsRecreation/entertainmentOther (please specify) Enter other… 4. What time did you usually leave home to travel to --insert city--? 4. What time did you usually leave home to travel to --insert city--? - Select -Before 9amBetween 9am - 11amAfter 11amOther (please specify) Enter other… 5. What time did you usually leave --insert city-- to travel to home? 5. What time did you usually leave --insert city-- to travel to home? - Select -Before 12 noonBetween 12 noon - 2pmBetween 2pm - 3pmAfter 3pmOther (please specify) Enter other… 6. How did you usually get to --insert city--? 6. How did you usually get to --insert city--? - Select -Car as driverCar as passengerMotorbikeCommunity TransportTaxiOther (please specify) Enter other… 7. Did you use the same mode to get home? - Select -YesNo Why not? 8. Would you consider using the on demand bus service to travel to --insert city--? - Select -YesNo Why not? 9. Initially, the trial service will operate on Wednesdays. More days may be added depending on demand. What are your preferred days of the week for using Cooee Busways? - Select -MondayTuesdayWednesdayThursdayFridayAny day Additionally, you may choose a second day preference noneMondayTuesdayWednesdayThursdayFridayAny day 10. Would you require assistance using a bus? - Select -YesNo Please describe assistance required (e.g. fold out ramp) 11. Do you currently hold a driver's license? - Select -YesNo 12. What types of transport options are available to you? 12. What types of transport options are available to you? - Select -CarMotorbike/scooterOther (please specify) Enter other… 13. Feedback on the proposed trial route service 14. What is your age? - Select -Under 1717 - 35 years36 to 44 years45 to 65 years65 to 80 yearsOver 80 years 15. What is your employment status? 15. What is your employment status? - Select -WorkingStudentUnemployedRetiredHousehold duties/caring for dependantsOther… Enter other… Stay updated If you would like to stay up to date on news about Cooee Busways, please provide one or more ways we can contact you Full name First name Last name Contact number Email Address Street Address Address 2 City/Town Post code