Please review the information below. If everything is correct, click “Send”. To go back and edit your entries, click “Edit”.
The following required items were not provided or are in the wrong format. Please provide the required responses and submit again:
Survey Date (mm/dd/yyyy)
SURVEY NUMBER (Enter the number from the TOP LEFT Corner of the form. REQUIRED )
1. Where are you coming from? (Give full street address, nearest street intersection, name of company or building)
Address
Community State
Country
2. Where are you going to? (Give full street address, nearest street intersection, name of company or building)
Address
Community State
Country
3. Describe the place you are coming from:
IF OTHER, Please Specify
4. Describe the place you are going to:
IF OTHER, Please Specify
5. By what method are you leaving the airport ?
IF OTHER, Please Specify
6. Was your flight nonstop to Milwaukee ? Yes No
7. If NO, where did you stop ? CITY STATE
8. What fare did you pay for this trip ?
9. Is this part of a roundtrip ? Yes No
10. How often do you typically make this trip ?
11. What airline did you arrive on ?
12. What was your time of arrival ?
13. What is your gender ? Male Female
14. What is your age ?
15. What was the combined yearly income for your household in 2010 ? (Optional)
16. If different from the addresses listed above, what is you home address ? (Give full street address or nearest street intersection)
Address
Community State
Country
Thank you.