Complete this survey to have a chance to win a gas or grocery card! Surveys must be completed and either dropped off or mailed to 907 W. Pines Road, Oregon, IL 61061 or 510 Lincoln Hwy, Rochelle, IL 61068 by May 13, 2023 Phone Number or Email* What town do you currently live in? How many days a week are you physically active? None O Minimal, 1-2 O Moderate, 3-4 On average, how far do you drive to access a recreational facility? (YMCA, local park district, gym, etc.) O 0-5 miles 06-10 miles O 11+ miles How many times in a week do you utilize a recreational facility? 00-1 02-3 04-5 06-7 On average, how far do you drive to access a green space? (state parks, walking trails, etc.) 00-5 miles O 6-10 miles 11+ miles How many times in a week do you utilize a green space? (weather permitting) 00-1 O2-3 04-5 06-7 On a scale of 1-10, how safe do you feel in your current neighborhood? 1 2 3 4 5 6 7 8 9 10 DOO Not safe 0000 at all How would you rate the side walk accessibility in your neighborhood? 1 2 3 4 5 6 7 8 9 10 DOO None or not safe OOO0 sidewalks COLLECORATS HEALTH APARTMAY Extremely safe What would you like to see done in your town regarding the t current built environment? Want to take survey online instead? Scan Here Safe and accessible Complete this survey to have a chance to win a gas or grocery card ! Surveys must be completed and either dropped off or mailed to 907 W. Pines Road , Oregon , IL 61061 or 510 Lincoln Hwy , Rochelle , IL 61068 by May 13 , 2023 Phone Number or Email * What town do you currently live in ? How many days a week are you physically active ? None O Minimal , 1-2 O Moderate , 3-4 On average , how far do you drive to access a recreational facility ? ( YMCA , local park district , gym , etc. ) O 0-5 miles 06-10 miles O 11+ miles How many times in a week do you utilize a recreational facility ? 00-1 02-3 04-5 06-7 On average , how far do you drive to access a green space ? ( state parks , walking trails , etc. ) 00-5 miles O 6-10 miles 11+ miles How many times in a week do you utilize a green space ? ( weather permitting ) 00-1 O2-3 04-5 06-7 On a scale of 1-10 , how safe do you feel in your current neighborhood ? 1 2 3 4 5 6 7 8 9 10 DOO Not safe 0000 at all How would you rate the side walk accessibility in your neighborhood ? 1 2 3 4 5 6 7 8 9 10 DOO None or not safe OOO0 sidewalks COLLECORATS HEALTH APARTMAY Extremely safe What would you like to see done in your town regarding the t current built environment ? Want to take survey online instead ? Scan Here Safe and accessible