OMB #2120-0744
Expiration Date: 9/30/2015
National Park Service
[NAME OF PARK] Visitor Survey
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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.
Is this your first visit to (NAME of SITE) or had you visited here before?
First visit
Visited before Answer a
Approximately how many times have you visited (NAME of SITE) before?
Times before ________ (approximate)
Don’t know /not sure
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 |
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Did you take part or not take part in each of the following activities during this visit to (NAME of SITE)?
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Take part |
Not take part |
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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.)
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Not relevant |
Not at all |
Slightly |
Moderately |
Very |
Extremely |
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During this visit to (NAME OF SITE) how much did you…
(Mark “Not relevant” if an experience was not relevant for this visit.)
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Not relevant |
Not at all |
Slightly |
Moderately |
Very |
Extremely |
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Answer Question A, B, and C about each of the sounds you heard during this visit to (NAME of SITE). (Mark “Not hear” if sound not present.)
SOUNDS |
Not hear |
A. How acceptable or unacceptable was this sound during this visit to (NAME OF SITE)? |
B. How much did this sound please or annoy you during this visit to (NAME OF SITE)? |
C. How much did this sound positively add to or negatively detract from your experience during this visit to (NAME of SITE)? |
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--Unacceptable-- |
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--Acceptable-- |
--Annoy-- |
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--Please-- |
Negatively detract |
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--Positively add - |
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Extremely |
Very |
Moderately |
Slightly |
Neutral |
Slightly |
Moderately |
Very |
Extremely |
Extremely |
Very |
Moderately |
Slightly |
Neutral |
Slightly |
Moderately |
Very |
Extremely |
Extremely |
Very |
Moderately |
Slightly |
Neutral |
Slightly |
Moderately |
Very |
Extremely |
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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 11 on page 8.
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
How much did the sound from aircraft interfere with each of the following aspects of this visit to [NAME OF PARK OR SITE IN PARK]?
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Not relevant |
--------------- Aircraft sound interfered --------------- |
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Not at all |
Slightly |
Moderately |
Very |
Extremely |
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To what extent to would you support or oppose each of the following potential actions at [NAME OF PARK]?
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Strongly Support |
Support |
Neither Support nor Oppose |
Oppose |
Strongly Oppose |
Don’t Know/ Not Sure |
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Background Information
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 |
Were you or your personal group part of some larger commercial, educational, or other organized group of visitors?
Yes
No
What is your gender?
Male
Female
In what year were you born?
Year |
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1 |
9 |
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Where do you live?
United States What is your Zip code? |
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Another country What country do you live in? |
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What is the highest level of formal education you have completed?
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
Are you Hispanic or Latino?
Yes
No
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. 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:
File Type | application/msword |
File Title | National Park Service |
Author | Amanda Rapoza |
Last Modified By | Dahl, Taylor CTR (FAA) |
File Modified | 2015-09-16 |
File Created | 2010-02-01 |