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Travel Day Date

Mon

Tue

Wed

Thurs

Fri

Sat

Sun

Number of questionnaires Section I : Household Data A) Address : . .. House Number, Street Name City/Town Country B) Number of people living on this address C) Number of Transport : Car D) Household Income : RM 1000 RM 1001 - 2000 RM 2000 - 3000 RM 3001 Van Pickup Bicycle Motorcycle Other

Zip Code

E) Distance from home to main road (km) : 0.5 0.6 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 > 5.0

Section II : Data on Person Household A Person Number B Relation to Head C Age D Sex F/M E Licensed to Drive Y/N F Industry/ School G Mode Trip on Travel Day H Mode Trip While at Work I Made other Trips on Travel Day J Mode of Transportation

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Code 1 2 3. 4 5 6 7 8 9

Age 5-10 1115 16-20 21-25 26-35 .36-45 46-55 56-65 >65

Code 1 2 3. 4 5 6 7 8 9 0

Relation Head Spouse Son Daughter Grandparent Grandchild Other relative Unrelated Out-of-area visitor Unknown

Section III : Travel Trips for Purpose (in one week) Distance from Home (km) Travel time (minutes) Mode of Transport
Bicycle Motorcycle Car / Van Pick up Other

Mode of Trip Shopping Childcare/School Errands Work Visiting Medical Appointments Daycare/Babysitter Others

Number of Trips 0 1 2 3 4 >4

Section IV : Public Transportation A) Distance from home to nearest bus stop (km): 0.5 0.6 1.0 1.5 2.0 Bus Taxi 2.5 3.0 Y Y N N Y N 3.5 4.0 4.5 5.0 > 5.0

B) Would you ever ride a.

C) Are busses / taxi available during the times of day you regularly travel ? D) Reasons for not using public transportation : Reasons No public transport services provided in village Not enough quantity of bus/taxi is provided in nearest town Having problems with travel time using public transportation (too many stopping points) The nearest bus stop is far from home Difficult to travel with children Others 1 Worst 2 Bad Ranking 3 Better

4 Good

5 Excellent

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Section V : The Condition of Rural Road A) Are condition of existing rural road in your village affecting your travel trips? B) Reasons why the condition of existing rural road affecting your travel trips : Reasons The condition of rural roads (gravel roads) The existing travel lanes (width) not adequate for vehicle traffic volumes and truck traffic The horizontal curvature is not excessive, so wheels of large trucks do not track onto the shoulder C) How frequently the existing rural road give rise to villager : Rarely Almost every time Always Ranking 3 Better

1 Worst

2 Bad

4 Good

5 Excellent

D) Are the existing rural road ever doing maintenance or services ?

E) In your opinion, are the existing rural road need for maintenance and services ? Y F) What your suggestion in order to improve the existing rural road ? 1) 2) 3) N