Outdoor activity survey wave C - 12 month follow-up

NATIONAL OC
EA

D ATMOSPHER
AN
IC

TRATION
NIS
MI
AD

C
NI

Outdoor Activity Survey

D

ER

S.

CE

U.
EP

AR

TME

O
NT OF C

MM

Please complete for those household members whose information is shown below.

START HERE
„ P
 lease use a black or blue pen to
complete this form.
„ Mark

to indicate your answer.

„ If you want to change your answer,
darken the box and mark the
correct answer

Household Member 1

Now we would like to know about
activity that may have occurred in the
eight months since you answered the
previous questionnaire. The names,
age and gender of each household
member has been filled in for you.
Please respond only for these persons
– if someone else is now living here
who was not here previously, there is
no need to answer for this person.

Household Member 2

Name: «Name»

Gender: «Gender»

Age: «Age»

1. Is this person still a member of the household?

Age: «Age»

2. Is this person of Hispanic, Latino, or
Spanish origin?
Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

Gender: «Gender»

Name: «Name»
Age: «Age»

1. Is this person still a member of the household?

Yes
No Æ Go to household member 3

Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

Gender: «Gender»

Household Member 4

Name: «Name»

1. Is this person still a member of the household?

Yes
No Æ Go to household member 2

Household Member 3

Name: «Name»

2. Is this person of Hispanic, Latino, or
Spanish origin?

Several months ago, this household
responded to a brief questionnaire
about the people living here. Some
of the questions in that survey
asked about recreational saltwater
fishing activities, over the previous
12 months, by members of this
household.

OMB Control No. 0648-xxxx
Expiration Date: xx/xx/xxxx

Yes
No Æ Go to household member 5
2. Is this person of Hispanic, Latino, or
Spanish origin?

Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

Age: «Age»

1. Is this person still a member of the household?

Yes
No Æ Go to household member 4
2. Is this person of Hispanic, Latino, or
Spanish origin?

Gender: «Gender»

Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.

b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.

b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.

b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013

Go to Household Member 2

Go to Household Member 3

Go to Household Member 4

Go to Household Member 5 on the next page

Please useother side for
additional household members

Please complete for those household members whose information is shown below.

Household Member 5

Household Member 6

Name: «Name»
Age: «Age»

1. Is this person still a member of the household?

Yes
No Æ Thank you!
2. Is this person of Hispanic, Latino, or
Spanish origin?

Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

Age: «Age»

1. Is this person still a member of the household?

Yes
No Æ Go to household member 6
2. Is this person of Hispanic, Latino, or
Spanish origin?

Gender: «Gender»

Yes, of Hispanic origin
No, not of Hispanic origin
3. What is this person’s race?
Mark one or more boxes.

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

White Black, African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

4. For each time period below, on how many days
did this person go recreational saltwater fishing
in North Carolina from:

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

Days in Jan., Feb., March, April 2014

Days in Jan., Feb., March, April 2014

Days in Sept, Oct, Nov, and Dec. 2013

Days in Sept, Oct, Nov, and Dec. 2013
b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.
Days in Jan., Feb., March, April 2014

C
NI

D ATMOSPHER
AN
IC

U.

Days in Jan., Feb., March, April 2014

TRATION
NIS
MI
AD

b. A boat – include a private or rental boat that
returned to shore in North Carolina. Do not
include charter boats - rental or commercial
boats that include a captain or crew who help
locate and catch fish. Enter “0” if none.

S.

D

EP

ER

a. The shore – include docks, bridges,
causeways, beaches, banks or any other
shore-based structure or area. Enter “0”
if none.

CE

Gender: «Gender»

Outdoor Activity Survey

NATIONAL OC
EA

Name: «Name»

Days in Sept, Oct, Nov, and Dec. 2013
Go to Household Member 6

Days in Sept, Oct, Nov, and Dec. 2013
Thank you!

AR

TME

O
NT OF C

MM

Public reporting burden for this collection of information is estimated to average 10 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 suggestions for
reducing this burden to Rob Andrews, NOAA Fisheries Service, 1315 East-West Hwy., Silver
Spring, MD 20910.

This is a voluntary survey, and responses are kept confidential as required by section 402(b) of the MagnusonStevens Act and NOAA Administrative Order 216-100, Confidentiality of Fisheries Statistics, and will not be
released for public use except in aggregate statistical form without identification as to its source. Notwithstanding
any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a
penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork
Reduction Act, unless that collection of information displays a currently valid OMB Control Number.