Form 2120-0744 A 2120-0744 A Human Response to Aviation Noise - Visitor Survey, versi

OMB #2120-0744

Expiration Date: 9/30/2015

National Park Service

[NAME OF PARK] Visitor Survey

Your participation in the survey is voluntary. There are no penalties for not answering some or all questions, but since each participant will represent many others who will not be surveyed, your cooperation is extremely important. The answers you provide will remain anonymous. Our results will be summarized so that the answers you provide cannot be associated with you or anyone in your group or household.

PAPERWORK REDUCTION ACT statement: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject 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. The OMB Control Number for this information collection is 2120-0744. Public reporting for this collection of information is estimated to be approximately 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ASP-110.

Introduction

Welcome to the National Park Service visitor’s experience questionnaire. Your answers will inform National Park managers about visitors’ experiences at many different types of natural, cultural and historical sites in the United States. This questionnaire asks about your experiences during this visit to (NAME OF SITE).

Please wait to begin until the interviewer provides instructions on the first page.

1. Is this your first visit to (NAME of SITE) or had you visited here before?

First visit

Visited before Answer a

1. Approximately how many times have you visited (NAME of SITE) before?

Times before ________ (approximate)

Don’t know /not sure

2. During this visit to (NAME OF SITE) did you go to or not go to each of the following locations?

REVISION NOTE: This question must be individually formatted for each site. Identifying locations within the site may require maps, photos or other aids in addition to names.		Go to 	Not go to or uncertain 
_____________________
____________________
Other location [Please describe.]

3. Did you take part or not take part in each of the following activities during this visit to (NAME of SITE)?

   		Take part 	Not take part 
   Viewing the scenery
   Viewing a sunrise or sunset
   Picnicking or having a meal
   Watching birds
   Viewing wildlife (other than birds)
   Hiking or walking
   Camping
   Entering a visitor center, lodge, store or other building
   Attending a ranger-led talk, walk, or campfire program
   Attending some other demonstration, talk or other organized activity or performance [Please describe.]
   Other activity [What activity?]

4. How important was it that this visit to (NAME OF SITE) provide you with the opportunity to… (Mark “Not relevant” if an experience was not relevant for this visit.)

	Not relevant 	Not at all 	Slightly 	Moderately 	Very 	Extremely 
View the natural scenery
Enjoy the natural quiet and sounds of nature
Appreciate the history and cultural significance of the site
Experience a sense of adventure or challenge...

5. During this visit to (NAME OF SITE) how much did you…

(Mark “Not relevant” if an experience was not relevant for this visit.)

	Not relevant 	Not at all 	Slightly 	Moderately 	Very 	Extremely 
Appreciate the natural scenery
Enjoy the natural quiet and sounds of nature
Appreciate the history and cultural significance of the site
Experience a feeling of calmness, peace or tranquility
Experience a sense of adventure or challenge

6. Did you hear airplanes, jets, helicopters, or any other aircraft during this visit to (NAME OF SITE)?

Yes - heard

No –did not hear  Skip to 13 on page 9.

7. During this visit to (NAME OF SITE) how much did noise from airplanes, jets, helicopters or other aircraft bother, disturb or annoy you?

Not at all

Slightly

Moderately

Very

Extremely

8. How much did the sound from aircraft interfere with each of the following aspects of this visit to (NAME OF SITE)? (Mark “Not relevant” if an aspect was not relevant for this visit.)

	Not relevant 	--------------- Aircraft sound interfered ---------------
		Not at all 	Slightly 	Moderately 	Very 	Extremely
Enjoyment of the site
Appreciation of the natural quiet and sounds of nature at the site
Appreciation of the historical and cultural significance of the site

9. How much did the sound from aircraft interfere with each of the following aspects of this visit to (NAME OF SITE)? (Mark “Not relevant” if an aspect was not relevant for this visit.)

   	Not relevant 	------------- Aircraft sound interfered --------------
   		Not at all 	Slightly 	Moderately 	Very 	Extremely
   History and Culture Experiencing a sense of connection to the history, events or people commemorated here
   Nature Experiencing a sense of connection with nature
   Appreciating scenic beauty
   Other feelings Experiencing a feeling of calmness, peace or tranquility
   Experiencing a sense of adventure or challenges
   Listening to a presentation Hearing something said during a ranger talk, campfire program, or other ranger-led activity
   Hearing any other performance, talk or group presentation
   Nighttime experiences (Mark “Not relevant” if you did not stay at or visit this site at night.) Appreciating natural sounds at night
   Sleeping at night

10. How acceptable or unacceptable was the sound from aircraft that you heard during this visit to (NAME OF SITE)?

------ Unacceptable ------					------ Acceptable ------
Extremely 	Very 	Moderately 	Slightly 	Neutral 	Slightly 	Moderately 	Very 	Extremely 

Earlier: Q.6 asked: Did you hear aircraft?

Next: Q.11 asks: Did you see aircraft?

11. Did you see airplanes, jets, helicopters, or any other aircraft during this visit to (NAME OF SITE)?

No - -Did not see  Skip to 12 on next page.

Yes - Did see  Answer a

1. During this visit to (NAME OF SITE) did seeing aircraft bother, disturb or annoy you...

Not at all

Slightly

Moderately

Very

Extremely

12. Have you ever taken a scenic air tour over [NAME OF PARK] or any other park?

	Yes, Have 	No, Have not 
I have taken a scenic air tour over [NAME OF PARK].
I have taken a scenic air tour over another national park.

Background Information

15. How many adults and children were in your personal group (spouse, family, friends) on this visit to (NAME OF SITE)?

    Adults (age 16 or over)	Number
    Children (age 15 or under)	Number

16. Were you or your personal group part of some larger commercial, educational, or other organized group of visitors?

Yes

No

15. What is your gender?

Male

Female

15. In what year were you born?

    Year
    1	9

16. Where do you live?

United States  What is your Zip code? 
Another country  What country do you live in?

15. What is the highest level of formal education you have completed? (Check one.)

Some high school

High school graduate or GED

Some college, business or trade school

College, business or trade school graduate

Some graduate school

Master’s, doctoral or professional degree

15. Are you Hispanic or Latino? (Check one.)

Yes

No

15. What is your race? (Check all that apply.)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian

Pacific Islander other than Native Hawaiian

White

Please give your questionnaire to the interviewer.

Thank you for completing the survey!

PRIVACY ACT and PAPERWORK REDUCTION ACT statement: 16 U.S.C. 1a-7 authorizes collection of this information. This information will be used by park managers to better serve the public. Response to this request is voluntary. No action may be taken against you for refusing to supply the information requested. The permanent data will be anonymous. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The control number for this collection of information is 2120-0744. BURDEN ESTIMATE statement: Public reporting burden for this form is estimated to average 15 minutes per response. Direct comments regarding the burden estimate or any other aspect of this form to the FAA at: 800 Independence Ave. SW, Washington DC 20591, Attn: Information Collection Clearance Officer, AES-200.

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