Arctic National Wildlife Refuge Survey - Responses

Post Card – Example

Inside:

OMB No. 0596-xxxx, Exp xx/xx/xxxx

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-xxxx. The time required to complete this information collection is estimated to average 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Your Name: ______________________________________________________

Postal Address: ____________________________________________________

City: ______________________________ State/Country: __________________

Zip or Postal Code: ___ ___ ___ ___ ___

Email address: _____________________________________________________

Would you prefer to receive a survey about your trip to the Arctic National Wildlife Refuge by postal mail (US only) or email?

 Postal mail  Email

Today’s Date: (mm/dd/yyyy) ______/______/____________

(Fold on dotted line)

At what location did you receive this registration card?

___________________________________________

How did you obtain this registration card?

 Taxi pilot  Self-register at kiosk  Other

How long are you spending in the refuge on this trip? ________ day(s)

How many are in your group on this trip, including yourself? ___________

At what place or on what drainage are you starting your trip to the refuge?

___________________________________________

At what place or on what drainage are you ending your trip to the refuge?

___________________________________________

What is your primary purpose for visiting the refuge on this trip?

___________________________________________

Post Card – Example

Outside:

(Top half – outside)

Aldo Leopold Wilderness Research Institute

US Departments of the Interior and Agriculture

790 E. Beckwith Ave.

Missoula, Montana 59801

Arctic National Wildlife Refuge Visitor Survey (2015)

First Class Postage Stamp

(included)

(Bottom half – outside)