Summerlea United Church
225 50 Av, Lachine, Québec, H8T2T7, Canada. 514-634-2651
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Transportation Survey
Posted 15 Oct 2009
If you are not attending services or Church events because you lack means of transportation please check the first box and then fill out your contact information (Name, Address, etc.) in the fields near the bottom of the form.
If you have a car, please select the appropriate responses in the boxes below and then fill out your contact information (Name, Address, etc.) in the fields near the bottom of the form.
When you attend Church do you drive your car?
Always
Usually
Sometimes
Rarely
Never
If you drive to Church, how many passengers are normally with you?
None
One
Two
Three
Four
If you are willing to pick up people in your area to bring to Church, how many would/could you accommodate?
One
Two
Three
Four
Would you be willing to pick up folks for special events (e.g. evening concerts during the week or on a week-end) at the Church?
Yes
No
If you answered ‘yes’ to question four, how available are you usually?
Almost always
Occasionally
Only rarely
Name
Address
E-mail Address:
*
Phone number (### - ####)
Postal Code (### ###)
Please include any comments, suggestions or questions in the box below.
Verification Code
:
Enter Verification Code
:
*
*
Required
Survey Introduction
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