HOUSEHOLD TRAVEL SURVEY QUESTIONNAIRE
Date: ____ / ____ / _______
Survey Location (District/Zone): __________________
Surveyor Name: __________________
Section 1: Household Information
1. Household Size: _____ members
2. Household Income (monthly in local currency):
☐ Below 5,000 ☐ 5,000–10,000 ☐ 10,000–20,000 ☐ 20,000+
3. Number of Working Adults in Household: _____
4. Number of Students in Household: _____
5. Do you own a personal vehicle?
☐ No
☐ Yes, how many? Cars: __, Motorcycles: __, Bicycles: __
6. Do you have a driver’s license? ☐ Yes ☐ No
7. Does anyone in your household work remotely (from home)? ☐ Yes ☐ No
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Section 2: Individual Travel Information (Fill for each household member)
[Repeat this section for each family member aged 5 and above]
Individual 1
1. Age: _____
2. Gender: ☐ Male ☐ Female ☐ Other
3. Employment Status:
☐ Employed ☐ Student ☐ Unemployed ☐ Retired
4. Primary Mode of Transport (for most trips):
☐ Walk ☐ Bicycle ☐ Motorcycle ☐ Private Car ☐ Bus ☐ Taxi ☐ Train
5. Secondary Mode of Transport (if applicable):
☐ Walk ☐ Bicycle ☐ Motorcycle ☐ Private Car ☐ Bus ☐ Taxi ☐ Train
6. How many trips do you make per day? _____
7. Primary trip purpose:
☐ Work ☐ School ☐ Shopping ☐ Social/Recreation ☐ Other: ______
8. Average trip distance (one-way):
☐ Less than 2 km ☐ 2–5 km ☐ 5–10 km ☐ 10+ km
9. Average travel time (one-way):
☐ Less than 15 min ☐ 15–30 min ☐ 30–60 min ☐ 1+ hour
10. Do you face any transportation challenges? (Select all that apply)
☐ High cost ☐ Traffic congestion ☐ Lack of public transport ☐ Poor road
conditions ☐ Safety concerns ☐ Other: _________
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Section 3: Household Trip Generation Data
1. How many total trips does your household make per day? _____
2. Trips by purpose:
Work Trips: _____
School Trips: _____
Shopping Trips: _____
Recreation/Social Trips: _____
Other Trips: _____
3. Trips by mode:
Walk: _____
Bicycle: _____
Motorcycle: _____
Private Car: _____
Bus: _____
Taxi/Rideshare: _____
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Section 4: Future Transportation Needs
1. What would encourage you to use public transport more?
☐ Lower fares ☐ More routes ☐ Increased frequency ☐ Safer travel ☐
Nothing
2. Would you use cycling lanes if available? ☐ Yes ☐ No
3. Do you support carpooling/shared mobility options? ☐ Yes ☐ No
STATED PREFERENCE SURVEY QUESTIONNAIRE
Date: ____ / ____ / _______
Survey Location: __________________
Surveyor Name: __________________
Section 1: Respondent Information
1. Age: _____
2. Gender: ☐ Male ☐ Female ☐ Other
3. Employment Status:
☐ Employed ☐ Student ☐ Unemployed ☐ Retired
4. Primary Mode of Transport (most frequently used):
☐ Walk ☐ Bicycle ☐ Motorcycle ☐ Private Car ☐ Bus ☐ Taxi ☐ Train
5. Secondary Mode of Transport (if applicable):
☐ Walk ☐ Bicycle ☐ Motorcycle ☐ Private Car ☐ Bus ☐ Taxi ☐ Train
Section 2: Travel Preferences (Likert Scale Questions)
Please rate the following statements based on your level of agreement:
(1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly
Agree)
