Pledge Page

Q1) Name(Required)

Q2) Email(Required)

Q3) I pledge to NOT Drive Alone by Car on Monday, September 23, 2024(Required)

Yes
No

Q4) On Monday, September 23, 2024 I plan on doing the following: (check all that apply)(Required)

Working
Shopping/Errands
Taking Classes
Recreation/Exercise
Taking kids to/from school/daycare or activities
Dining Out/Entertainment
None of the Above

Q5) From where will you be working on Monday, September 23, 2024?(Required)

I Won’t be Working that Day
Working from Home
Co-working or Telework Center/Shared Workspace
Commuting to my Standard Workplace Location
Other Location

Q6) How many total round trip miles are between your typical home/work locations? (If none, use number zero)(Required)

Q7) How many total Car Free or Car-Lite (carpool/vanpool) miles will you travel to get around on Monday, September 23, 2024? (If none, use number zero)(Required)

Q8) If you go anywhere on Monday, September 23, 2024, how will you get there? (check all that apply)(Required)

Bicycle/Scooter
Car-Lite (Carpool/Vanpool)
Bus
Train
Walk/Run
Other
I Won’t be Leaving my Home that Day

Q9) Which method will you use for the greatest distance of travel on Monday, September 23, 2024?(Required)

Bicycle/Scooter
Car-Lite (Carpool/Vanpool)
Bus
Train
Walk/Run
Other method
None, I Won’t be Leaving my home that Day

Q10) If you didn’t take this pledge, would you still be Car Free/Car-Lite on Monday, September 23, 2024?(Required)

Yes
No

Q11) Home address (To become prize eligible, please provide your full mailing address.)

Q12) City

Q13) Zip code

Q14) Home County/Jurisdiction(Required)

Q15) Mobile Number (optional) to receive reminder text messages about Car Free Day: Please use XXXXXXXXXX format, no brackets, spaces or dashes.

Name

This field is for validation purposes and should be left unchanged.

Pledge Form