Headwaters Visitor Interview

OMB #xxxx-xxxx, Exp. 00/00/xxxx

Headwaters Forest Reserve Visitor Use Survey

On-Site Contact 2012

For the Research Technician:

1. Group ID Number:_______________________

2. Interviewer:____________________________

3. Date:_________________________________

4. Time:_______:________ (24 hour clock)

___________________________________________________________________________________________

1. How would you describe your group?

alone ( )

family only ( )

friends only ( )

family and friends ( )

organized club or school group ( )

other; please specify ( )________________________________________

2. How many people are in your group, including yourself?_______________________

3. Is this your first visit to the Headwaters Forest Reserve? Y N

4. If No, including this trip approximately how many times have you visited Headwaters Forest Reserve? _______

5. Do you have a dog with you today? Y N

6. Are you now entering or leaving the Headwaters Forest? entering

leaving

a. If leaving, when did you enter? time (24 hour clock)

b. If entering, when do you anticipate leaving? time (24 hour clock)

c. Enter visit duration in minutes ___________________

7. If you are now leaving, how far did your party travel on the trail on your visit? Please describe the farthest point you reached.

__________________________________________________________________________________

__________________________________________________________________________________

8. We would like to send a questionnaire to your home to get information on your use, enjoyment and management preferences for the Headwaters Forest. Could we do that? The BLM is trying to protect the Headwaters Forest and also provide the best possible recreational experiences. To do this we need your help. If we sent a questionnaire to you, would you be willing to fill it out and mail it back in the postage-paid envelope?

Collect up to two names and addresses from different households.

Name Address (Street, City, State, Zip)

1._____________________________________ ______________________________________________

______________________________________________

______________________________________________

_______________________________Zip____________

2._____________________________________ ______________________________________________

______________________________________________

______________________________________________

_______________________________Zip____________

THANK YOU!

Public reporting burden for this collection of information is estimated to average 7 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to U.S. Department of the Interior, Bureau of Land Management (1004-XXXX), 1849 C Street, NW, Room 2134LM, Attention:  Bureau Information Collection Clearance Officer (WO-630), Washington, D.C. 20240.

Script: Hi, my name is Dan and I am a student at Humboldt State. I am working with my professor to gather some visitor information for the BLM, who manages the Headwaters Forest Reserve. We are studying visitor satisfaction levels to learn how we can improve the visitor experience here at Headwaters. Could I have just a few minutes of your time for a few questions?

[Complete on-site form]