CYWB Employer Information Form

Choose Your Way Bellevue Employer Information
This is an optional survey to fill out so we can best assist you in developing your employee commute program, please submit the following information to Choose Your Way Bellevue staff. Staff will follow up by phone or email to schedule a meeting or call.
Last name*
First name*
Email*
Phone Number:*

Area CodePhone Number
Business Name*
Worksite Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Approximate number of employees*
Do you have an employee transportation program?*

YesNoNot sure
If so, please mark the program elements that are currently in place at your worksite.*

ORCA cardFree parkingA choice of parking or ORCADiscounted parking for carpools or vanpoolsPreferential parking for carpools or vanpoolsBike subsidyBike storageEmergency ride homeNon-drive-alone subsidyFlexible parkingI'm not sureOther
What is the monthly cost your employees pay for parking?
Approximately what percentage of employees currently take transit?
If you do provide a transit subsidy such as ORCA, how many employees are currently enrolled?
What alternative modes of transportation would you like to further expand or implement at your worksite?

TransitCarpoolVanpoolBikeTeleworkOther
Questions or Comments:
Should be Empty:

Choose Your Way Bellevue Employer Information