ROLLINS ROAD GATEWAY PROJECT TRAVEL SURVEY
Please help us solve congestion at the Rollins Road/IL-83 intersection by completing and mailing this survey. The survey consist of eight simple questions. No personal information is being requested.
1. When did you make this trip:
		Date:		< July 2010 > Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7
		Time of day:		Morning Midday Afternoon
2. My trip began at: (check one)
			Home	Personal Appointment
			Work	Business Appointment
			Shopping/Errands	Restaurant
			School	Metra Train Station
			Friend’s or relative’s home	Other (Please specify):
3. Where did this trip begin?
	Please indicate the city and the address or nearest intersection (provide both street names of intersection) where your trip began and ended.
			City/ Village:
			Address or Nearest Intersection
4. If you made stops on this trip, what was the purpose of these stops? (check all that apply)
			Home	Personal Appointment
			Work	Business Appointment
			Shopping/Errands	Restaurant
			School	Other (Please specify):
			Friend’s or relative’s home
5. Where did this trip end?
			City/ Village:
			Address or Nearest Intersection
6. My trip ended at: (check one)
			Home	Persoanl Appointment
			Work	Business Appointment
			Shopping/Errands	Restaurant
			School	Metra Train Station
			Friend's Relative's home	Other (Please specify):
7. How often do you typically make this trip? (check one only)
			Less thank once a week	1 to 5 times a week
			More than 5 times a week
8. I traveled on these roads during this trip (check all that apply):
			IL - 83	Grand Avenue (IL-132)
			Rollins Road	Cedar Lake Road
			Hainesville Road	Washington Street
			Hook Drive	Mallard Creek Drive
			Shorewood Road	Orchard Lane
Please give us your comments on the Rollins Road/IL-83 intersection:
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