Registration Survey
Travel to Work 2015

The Travel to Work survey 2015 will be taking place from 9th - 14th March 2015.
In order to ensure the smooth running of the survey we need some basic information from your organisation. Please ensure you read the 'Essential Info - Travel to Work Survey 2015' document circulated with this questionnaire before you fill it in.

Please submit this registration form by 28th February 2015.

	Your name:

	Company name*:

	Your contact email (this is where the link to the Travel to Work survey will be sent)*:

	Postcode (head office if you have several sites)*:

	Telephone:

	Total number of employees based in Bristol and South Gloucestershire:

Sites

Please provide details of any sites your organisation has in Bristol or South Gloucestershire with more than 50 staff.

	Site 1:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff at this site without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 2:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 3:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 4:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 5:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 6:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 7:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 8:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 9:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 10:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 11:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 12:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 13:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 14:
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

Do you have any other sites?

Yes

	Site 15 (please note this is the maximum amount of sites you can register):
	Name of site*

	Full postcode*

	Number of employees

Can computer-based staff at this site access external weblinks?

Yes

No, but we should be able to make the link accessible by checking it in advance

Do you need paper copies for staff without regular computer access? Please note we can only provide paper copies if online access to take the survey is not an option.

Yes

If you require paper copies, would you like...

A pdf for self-printing

Printed paper copies

	If you need printed paper copies, please tell us how many paper copies you need.

	If you need printed paper copies, please tell us which address to send them to:

	Are there any other IT issues at any of the sites that we need to consider?

How will you circulate the online link to the questionnaire to computer based staff? Please read the Essential Info document before answering.

Email to all staff

Intranet for all staff

Management cascade

Other

	If other, please specify:

To help promote the survey, we are able to provide you with a range of promotional materials. Please tick below which promotional material you would like to receive.

Powerpoint slide for digital screens

Pdf for printable poster for noticeboards

Jpg image for use on the intranet

News story about the impact of previous surveys to circulate to staff

Weblink to promotional video (available for South Gloucestershire organisations only)

Thank you for your registration. Please click on submit to send us your form.
Any personal data you have submitted will be processed and held by South Gloucestershire Council, Bristol City Council and North Bristol SUSCOM in accordance with the Data Protection Act. Personal information will not be published and will not be passed on to third parties. Anonymous findings may be shared with the funder (LSTF) and the University of the West of England.

* indicates a mandatory field.

Registration Survey Travel to Work 2015

Registration Survey
Travel to Work 2015