On-Site Survey
Introductory script to say to visitor:
Hi, I’m Trevor. I’m a student at Humboldt State University. We’re conducting a brief survey of visitors to this area for the Bureau of Land Management, which manages this site. Would you be willing to take a few minutes to answer a few short questions about your visit today?
You are one of a small number of people randomly chosen for this survey, so your opinions are important to us. Your participation in this survey is voluntary and all of your answers will remain completely anonymous. Please carefully read all directions and mark your responses clearly. There are no penalties for not answering any or all of the questions. Your cooperation is extremely important since each person surveyed will represent many others who will not be surveyed. Humboldt State University will summarize the results to the answers you provide. The information provided will not be used beyond the purposes of this study.
The Bureau of Land Management will use the comments you provide to improve customer satisfaction with BLM program areas. You do not have to respond to this or any other Federal-agency sponsored information collection which does not display a currently valid OMB control number. The public reporting burden is estimated to average 2 minutes for the initial contact and 5 minutes per response.
We have contact information if you want to comment on this survey or if you have questions.
[If contact information is requested, say: 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 (OMB # 1040-0001), 1849 C Street, NW, Room 2134LM, Attention: Bureau Information Collection Clearance Officer (WO-630), Washington, D.C. 20240. If you have any questions, please contact Steven Martin, at Humboldt State University, either by email [email protected] or by telephone (707-826-4147).]
Thank you very much for your help!
OMB control #1040-0001 Exp. 6/30/2015
*For Official Use Only* ID#________________ Location____________ |
Bureau of Land Management (BLM) Arcata Field Office
Recreation Visitor Survey
How many people are in your group today, including yourself? _________
2. How many times have you visited this area in the past 12 months, including this visit?
______
How about the last five years? ______
3. Please indicate all the activities from the list below that you will/have participated in at this BLM site (please check all that apply)
___Environmental Learning |
___ Social Gatherings |
___Viewing Interpretive Exhibits |
___ Bicycling: Mountain |
___Watching Wildlife |
___ Bicycling: Road |
___Visit Historic Sites |
___ Hiking/Walking |
___ Bird Watching |
___ Horseback Riding |
___ Canoeing/Kayaking |
___ Hunting |
___ Fishing |
___ Running |
___ Swimming |
___ Surfing |
___ Waterside Play/Sports |
___ Paragliding |
___ Surf Kayaking |
___ Dog Walking |
___ ATV Riding |
___ Photography |
___ Auto Touring/Sightseeing |
___ Picnicking |
___ Four-Wheel Driving |
___ Attending Special Events |
___ Motorcycling: Dirt Bike |
___ Write-In: ___________ |
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4. What type of group are you with during this visit?
I am visiting alone
Family only
Friends only
Family and friends
Organized group (e.g., church, scouts, etc.)
Commercially outfitted group
5. Which of the following statements best describes your visit to this area? (check one)
This management area is the main destination for this trip.
This management area is one of multiple destinations for this trip.
6. Are you? ____ Male ____ Female
7. In what year were you born? _________
8. In what state do you permanently reside? _________
9. In what zip code do you permanently reside? _________
Follow-up Script to read to visitor
Thank you for filling out this brief survey. Would you be willing to take home and complete a more detailed mail-back survey? The results will help the BLM provide the recreation opportunities you most want. Again, your participation in this study will be anonymous and your participation is completely voluntary. The mailing list will be destroyed after the survey is completed. Your name, address and/or email address will be used ONLY to contact you for this study and will not be shared. Would you be willing to take a mail survey home and fill it out?
[Hand the clipboard to respondent to fill in name and address, then provide with the mail survey and envelope.]
Information on clipboard:
Name ____________________________________________
Street Address ____________________________________
_____________________________________
_____________________________________
City ________________________ State ______ Zip Code _______
This address is your (check one):
___Permanent address ___Second home address ___Other seasonal address
If you prefer to complete the survey online, we will email a link to the survey to you. Please provide your email address. We will not share it or use it for any other purpose.
Email address: _______________________________________
This information will be used by the BLM to better serve the public. Your response to this request is voluntary. No action may be taken against you for refusing to supply the information requested. Your name and address are requested for follow-up mailing purposes only.
File Type | application/msword |
Author | Suzanne Denson |
Last Modified By | Donald Bieniewicz |
File Modified | 2015-06-17 |
File Created | 2015-06-17 |