Directions

Your Travel Date (Month/Day): ______ Your Travel Day: ________

What is your age? ______ Your gender? ________

Participant Name: _____________________________________________________ Street Address:

City: State: Zip: _______________________ Cell Phone #: _____________________

Type of Place (e.g., Your Home, Other Person’s Home, Work, Hotel, etc.): ________________

What time did you DEPART this place? _______

Where were you at 3:00 am today?

Please do/remember the following as you complete your diary:

Directions

Demographic and Contact Information

Demographic and Contact Information

Dubu que Dubuque Regional Personal Trip Survey TRAVEL DIARY Day 1

If You Don't Read Anything Else, Read This

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#1

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#2

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other _______________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

? What did you do at this location

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#3

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#4

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#5

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#6

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#7

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

________ Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#8

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#9

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? ________ What were the ages of the other household members traveling with you?

#10

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

Your Travel Date (Month/Day): ________ Your Travel Day: ________

Street Address:

City: State: Zip:

Type of Place (e.g., Your Home, Other Person’s Home, Work, Hotel, Store): _____________________

What time did you DEPART this place? _______

Where were you at 3:00 am today?

Dubuque Regional Personal Trip Survey TRAVEL DIARY Day 2

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#1

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#2

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#3

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#4

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#5

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#6

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#7

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

________ Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#8

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#9

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? ________ What were the ages of the other household members traveling with you?

#10

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

Your Travel Date (Month/Day): ________ Your Travel Day: ________

Street Address:

City: State: Zip:

Type of Place (e.g., Your Home, Other Person’s Home, Work, Hotel, Store): _____________________

What time did you DEPART this place? _______

Where were you at 3:00 am today?

Dubuque Regional Personal Trip Survey TRAVEL DIARY Day 3

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#1

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#2

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#3

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#4

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#5

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#6

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#7

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

________ Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

#8

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.

#

Where Did You Go?

What About Your Route?

What Did You Do?

What Was The Time?

How Did You Get There?

How Many Traveled?

#9

The First Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection)include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used? o Transit Bus (Route: ________ )

Other _________________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? ________ What were the ages of the other household members traveling with you?

#10

The Next Place

I Went

_____________________________Name or Description of Place _____________________________ Address (or nearest intersection) include suffix (St., Ave., lane, etc.) _________________ _____ City State __________ Zip (if known)

On your way to this location did you cross the Mississippi River? If YES: Which highway/road bridge did you use to cross the river?

What did you do at this location?

What time did you ARRIVE at this location? Time: ______

What time did you DEPART this location? (enter NA if you ended your travels for the day here) Time: ______

What was the primary type of transportation you used?

o Transit Bus (Route: ________ )

Other ___________________ I f you used a car, van, or truck for this trip . . . Were you the . . .?

Please indicate the following about the vehicle: Year ______ Make/Model_______

Was this your household’s vehicle?

Including you, how many people made this trip?

Including you, how many people from YOUR HOUSEHOLD were on this trip? What were the ages of the other household members traveling with you?

Place

Specify other here.

Specify other here.