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2. Where is the problem or hazard?*
   Please be as specific as possible. For example, you could include a street intersection or the street number of a nearby business or home.
4. Briefly describe the problem or hazard.*
   Provide information to help us understand why you feel unsafe or why this area is problematic when traveling by bike.
6. What do you suggest that might help remedy the situation?
10. Additional Information
    The questions below are optional but will help the City understand how its citizens travel by bike through town.
12. Why do you ride a bike in Brevard?

    1. Commute to work
    2. Run errands
    3. Recreation
    4. Exercise
    5. Other
13. How often do you ride in Brevard?

    1. Daily
    2. Several times per week
    3. Weekly
    4. Several times per month
    5. Monthly
    6. A few times per year
15. In your opinion, what are the two most important types of destinations to be able to connect to on a bike?

    1. Work/employment centers
    2. Retail/shopping (including grocery and drug stores)
    3. Community facilities (such as the library)
    4. Recreational facilities
    5. Residential neighborhoods
    6. Schools
    7. Other
16. How safe do you feel riding a bike in Brevard?

    1. Very safe
    2. Somewhat safe
    3. Neutral
    4. Somewhat unsafe
    5. Very unsafe
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field