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CommuteInfo: A Better Way To Work
For Employers: Employee Survey

Remember: fields marked with an asterisk (*) are required!!

*Code:
*E-mail Address:
*First Name:
  
*Last Name:

What are your typical work hours?

* Zip Code:
Sunday:
*Start Time: :   *End Time: :  
Monday:
*Start Time: :   *End Time: :  
Tuesday:
*Start Time: :   *End Time: :  
Wednesday:
*Start Time: :   *End Time: :  
Thursday:
*Start Time: :   *End Time: :  
Friday:
*Start Time: :   *End Time: :  
Saturday:
*Start Time: :   *End Time: :  

* How do you currently travel to work? (Check All That Apply?)

Drive Alone
Carpool
Vanpool
Bus
The "T"
Walk

* Are you able to telecommute?
Yes No
If so, how many days per week?
1 2 3 4 or more

* Are you able to work a compressed schedule?
 Yes No
If so, which day are you off?
Monday Friday

The CommuteInfoSM Program:
A Program of the Southwestern Pennsylvania Commission

Regional Enterprise Tower
425 Sixth Avenue, Suite 2500 * Pittsburgh, PA 15219-1852
1-888-819-6110

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CommuteInfo@spcregion.org
or call 1-888-819-6110

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