I am one of the team that is working with ACC about Motorbike Safety. If you live in Auckland you may have noticed our "Lookout for Motorbikes " Campaign on the motorway off ramps in previous years. Our campaign this year is safety gear.
If you fill in this form, you are in the draw for a MTA Voucher and hi viz vest. But it has to be done by 21 December 2006.
SURVEY QUESTIONS FOR MOTORCYCLISTS (BE IN TO WIN A $50 MTA VOUCHER & HI VIZ VEST 5 TO BE WON)
1 How long have you been riding a motorbike? Years .Months .
2 Do you own safety gear? Yes / No
If so, do you have high visibility gear? Yes / No
Do you wear it? Yes / No
If not, would you tell us why?
Would you wear safety gear if you had any? Yes / No
3 How far do you travel on your bike? (in kilometres, approximately)
Per Day .. Per Week .Per month
4 How often do you ride your bike?
5 Recreation/work use?
6 Have you been involved in a motorcycle crash/near miss?
7 Have you ever done any motorcycle training?
Which city/district do you reside in: Rodney / North Shore / Waitakere / Auckland City / Manukau / Papakura / Franklin / Other? ..
Male / Female
Age: (circle one)
Under 15 / 16 25 / 26 35 / 36 45 / 46 55 / 56 65 / 66 & over / not stated
Your name and contact number for prize draw .
(Draw to be held 21 December 2006)
Send completed questionnaire to David Peirce, ACC Henderson, Private Bag 93107 or fax to (09) 915 8101 or e mail David Peirce at David.Peirce@acc.co.nz
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