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Do you live in a 40-50 mile radius of Bloomington/Normal Illinois?
 
yes
 
no
 
 
 
what town do you reside in/ what town do you work in? (xxx/xxx)
   
 
 
 
how many days to you drive per week and per month (x/xx)
   
 
 
 
how many cars do you supply gas for?
   
 
 
 
How many miles do you drive per day/ per month? (xxx/xxxx)
   
 
 
 
How many others do you know that make this same trip?
   
 
 
 
would you be willing to cut the ammount of money you spend on gas by half or more?
 
yes
 
no
 
 
 
Would you be interested in reducing the consumption of foreign oil while creating a greener environment for the community and supporting this idea?
 
Yes
 
No
 
 
Contact Information (optional)*
First Name : 
Last Name : 
Phone : 
Email Address : 
 
 
 
In what ways can this survey be improved?
   
 
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