Low-cost transport solution on-demand

Utility *

We are designing a van service to help you to be more mobile. Could this help you and your family?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Timing *

When would it be most helpful for you to use the services of the van? (You can select more than one option)

Early morning: 5am - 8am

Mid-morning: 8am - 12 noon

Afternoon: 12 noon - 5pm

Evening: 5pm - 9pm

Late night: 9pm - 12 midnight

Twilight zone: 12 midnight - 3am

Your Transport Challenges

Can you tell us what stands in the way of you getting around easily?

Public transport does not go where I need to go

Public transport is not available when I need it

Cost - cost of public transport or running a car

Feeling safe - I do not feel safe

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone (optional)

(###)

###

####

Do you have reliable access to the internet on a smart device so that you could request a ride using the internet? *

Choose the answer that best describes your circumstances.

Yes, I have access and can use the internet.

No, I don't have access to the internet.

No, I don't feel confident using the internet.

Do you have reliable access to a phone line so that you could request a ride by phone? *

Yes.

Yes, provided someone spoke my language at the other end.

No.