School Travel Tally Form
Thank you for taking the time to complete this form.  It should take less than 5 minutes to complete.  

Please conduct these counts on two days out of the week
Before asking your students to raise their hands, please read through all possible answer choices so they will know their choices. Each Student may only answer once.
Ask your students as a group the question "How did you arrive at school today?"
Then, reread each answer choice and record the number of students that raised their hands for each. Place just one character or number in each box.
Follow the same procedure for the question "How do you plan to leave for home after school?"
You can conduct the counts once per day but during the count please ask students BOTH the school arrival and departure questions.
Please conduct this count regardless of weather conditions (i.e., ask these questions on rainy days, too).

This survey utilizes the same questions as the survey used for decades by the National Center for Safe Routes to School. The purpose of this form is to help us understand how children get to and from school, and to determine changes in patterns over the years.  These insights will help us determine whether we have been successful in our collective efforts to increase rates of walking and rolling to school.   Your answers will be extremely valuable for improving your school's Safe Routes to School programming.  Thank you very much for your time.

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School Name *
Tip: start typing the name of your school--your school name should show up.  If your school's name is definitely not on the list, you can enter it below
School Name (if not on list)
City *
Tip: start typing the name of your city, and it will scroll to that section
Grade *
Teacher Name *
Month *
Season *
Weather *
Number of Students Enrolled in Class *
Number of Students Present in Class *
Ask Students: How did you arrive at school today?
Read through the options to the students before asking the questions:

Walk
Bike
School bus
Family Vehicle (only with children from your family)
Carpool (Riding with  children from other families)
Transit (city bus, subway, etc)
Other (skateboard, scooter, etc)
Number of Students who Arrived at School by WALKING *
Number of Students who Arrived at School by BIKING *
Number of Students who Arrived at School by SCHOOL BUS *
Number of Students who Arrived at School by FAMILY VEHICLE *
Only with children from your family
Number of Students who Arrived at School by CARPOOL *
With children from other families
Number of Students who Arrived at School by TRANSIT *
City bus, subway, etc
Number of Students who Arrived at School by OTHER WAY *
Skateboard, scooter, etc
Ask Students: "How do you plan to leave for home after school today?"
Number of Students who plan to leave school by WALKING *
Number of Students who plan to leave school by BIKING *
Number of Students who plan to leave school by SCHOOL BUS *
Number of Students who plan to leave school by FAMILY VEHICLE *
Only with children from your family
Number of Students who plan to leave school by CARPOOL *
With children from other families
Number of Students who plan to leave school by TRANSIT *
City Bus, Subway, etc
Number of Students who plan to leave school by OTHER *
Scooter, skateboard
Please list any disruptions to these counts or any unusual travel conditions to/from the school on the days of the tally.
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