Weather and outdoor activity survey

HOUSEHOLD MEMBER 4

HOUSEHOLD MEMBER 5

11 . What is this person’s gender?

11 . What is this person’s gender?

Male

Male

Female

Female

12 . How old is this person?
If less than 1 year, mark 0 years
Age in years
13 . Is this person of Hispanic, Latino, or Spanish origin?

12 . How old is this person?
If less than 1 year, mark 0 years
Age in years
13 . Is this person of Hispanic, Latino, or Spanish origin?

Yes, of Hispanic origin

Yes, of Hispanic origin

No, not of Hispanic origin

No, not of Hispanic origin

14 . What is this person’s race? Mark one or more boxes.

14 . What is this person’s race? Mark one or more boxes.

White

White

Black, African American

Black, African American

Asian

Asian

American Indian or Alaska Native

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Native Hawaiian or Other Pacific Islander

Please think only about recreational saltwater fishing in
.

Please think only about recreational saltwater fishing in
.

15 . How many days did you go recreational saltwater fishing
from the shore in ? The shore includes
docks, bridges, causeways, beaches, banks, or any other
shore-based place or area. Do NOT include freshwater
fishing.

15 . How many days did you go recreational saltwater fishing
from the shore in ? The shore includes
docks, bridges, causeways, beaches, banks, or any other
shore-based place or area. Do NOT include freshwater
fishing.

No shore recreational saltwater fishing in last 12
months
Go to question 16

No shore recreational saltwater fishing in last 12
months
Go to question 16

Number of days in January and February
of 2015

Number of days in January and February
of 2015

Total number of days in last 12 months,
including Jan and Feb
16 . How many days did you go recreational saltwater fishing
from a private or rental boat that returned to shore in
? Do not include freshwater trips or trips
where a paid captain or crew helped locate and catch fish.
No private boat recreational saltwater fishing in last
12 months
Go to Household Member 5
Number of days in January and February
of 2015
Total number of days in last 12 months,
including Jan and Feb
If you have more household members,
continue to household member 5.

Barcode

Weather and Outdoor
Activity Survey

Total number of days in last 12 months,
including Jan and Feb
16 . How many days did you go recreational saltwater fishing
from a private or rental boat that returned to shore in
? Do not include freshwater trips or trips
where a paid captain or crew helped locate and catch fish.
No private boat recreational saltwater fishing in last
12 months
Number of days in January and February
of 2015
Total number of days in last 12 months,
including Jan and Feb
Please return your survey to Gallup in the
enclosed postage paid envelope.

Language

Public reporting burden for this collection of information is estimated to average 10 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. Send comments regarding this burden estimate or any other suggestions for reducing this burden to Rob Andrews, NOAA
Fisheries Service, 1315 East-West Hwy., Silver Spring, MD 20910.
This is a voluntary survey, and responses are kept confidential as required by section 402(b) of the Magnuson-Stevens Act and NOAA
Administrative Order 216-100, Confidentiality of Fisheries Statistics, and will not be released for public use except in aggregate statistical
form without identification as to its source. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall
any person be subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork
Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

OMB Control No. 0648-0652
Expiration Date: 10/31/2016

This survey should be filled out by an adult member of the household. Return this form
even if no one in your household participates in any of these activities.

START HERE
EXAMPLE

Please carefully follow the steps below when completing this survey.
•

Use only a blue or black ink pen that does not blot the paper

•

Make solid marks inside the response boxes

•

Do not make other marks on the survey

1 . How do members of this household obtain
information about the weather, including
current weather conditions, forecasts, and
warnings? Mark all that apply.

RIGHT
WAY

WRONG
WAY

HOUSEHOLD MEMBER 1 (YOU)

HOUSEHOLD MEMBER 2

HOUSEHOLD MEMBER 3

11 . What is your gender?

11 . What is this person’s gender?

11 . What is this person’s gender?

Male

Male

Male

Female

Female

Female

12 . How old are you?
If less than 1 year, mark 0 years
Age in years

7 . Which category best describes the
telephone service for you and members of
the household?
Regular or Landline phone only

13 . Are you of Hispanic, Latino, or Spanish origin?

12 . How old is this person?
If less than 1 year, mark 0 years
Age in years
13 . Is this person of Hispanic, Latino, or Spanish origin?

12 . How old is this person?
If less than 1 year, mark 0 years
Age in years
13 . Is this person of Hispanic, Latino, or Spanish origin?

Yes, of Hispanic origin

Yes, of Hispanic origin

Yes, of Hispanic origin

No, not of Hispanic origin

No, not of Hispanic origin

No, not of Hispanic origin

14 . What is your race? Mark one or more boxes.

14 . What is this person’s race? Mark one or more boxes.

14 . What is this person’s race? Mark one or more boxes.

Television

Cellular phone only

Radio

Both Landline and Cellular phone

White

White

White

Newspaper

No working phone service

Black, African American

Black, African American

Black, African American

Asian

Asian

Asian

American Indian or Alaska Native

American Indian or Alaska Native

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Native Hawaiian or Other Pacific Islander

Native Hawaiian or Other Pacific Islander

Internet
Other

8 . Which of the following best describes this
house, apartment, or mobile home?
Owned with a mortgage or loan

2 . During the past 12 months, has anyone in
this household had to evacuate or seek
shelter due to a severe weather event such
as a tornado, hurricane, or thunderstorm?

Owned (without a mortgage)
Rented
Occupied without payment or rent

Yes
No

9 . How long have you lived at this address?
1 year or less

3 . In your area, how often do the advanced
warnings you get for severe weather
events allow you enough time to prepare
properly?
All the time
Some of the time

Less than 5 years, more than 1 year

10 . How many people, including all adults and
children, live in this household?
Number of people

Never
4 . During the past 12 months, has anyone in
this household visited a public beach,
national seashore, coastal state park, or
other coastal nature reserve or protected
area?
Yes
No
5 . During the past 12 months, has anyone in
this household been freshwater fishing in
?

Continue answering the Household
Member questions for each
household member, starting with
yourself. Please answer for all
household members, including those
who fish and those who do not fish.
If you have more than 5 people living
at this address, answer for the oldest
members of the household.
Please use the calendars to help
answer question 15 and 16.

Yes
No
6 . During the past 12 months, has anyone in
this household been saltwater fishing in
?
Yes
No

JANUARY 2015
S

M

T

4
11
18
25

5
12
19
26

6
13
20
27

W
1
7
14
21
28

T
1
8
15
22
29

F
2
9
16
23
30

Please think only about recreational saltwater
fishing in .

15 . How many days did you go recreational saltwater
fishing from the shore in ? The
shore includes docks, bridges, causeways, beaches,
banks, or any other shore-based place or area. Do
NOT include freshwater fishing.

15 . How many days did you go recreational saltwater
fishing from the shore in ? The
shore includes docks, bridges, causeways, beaches,
banks, or any other shore-based place or area. Do
NOT include freshwater fishing.

15 . How many days did you go recreational saltwater
fishing from the shore in ? The
shore includes docks, bridges, causeways, beaches,
banks, or any other shore-based place or area. Do
NOT include freshwater fishing.

S
1
8
15
22

M
2
9
16
23

T
3
10
17
24

W
4
11
18
25

T
5
12
19
26

F
6
13
20
27

Number of days in January and February
of 2015

S
7
14
21
28

No shore recreational saltwater fishing in last
12 months
Go to question 16
Number of days in January and February
of 2015

No shore recreational saltwater fishing in last
12 months
Go to question 16
Number of days in January and February
of 2015

Total number of days in last 12 months,
including Jan and Feb

Total number of days in last 12 months,
including Jan and Feb

Total number of days in last 12 months,
including Jan and Feb

16 . How many days did you go recreational saltwater
fishing from a private or rental boat that returned to
shore in ? Do not include
freshwater trips or trips where a paid captain or
crew helped locate and catch fish.

16 . How many days did you go recreational saltwater
fishing from a private or rental boat that returned to
shore in ? Do not include
freshwater trips or trips where a paid captain or
crew helped locate and catch fish.

16 . How many days did you go recreational saltwater
fishing from a private or rental boat that returned to
shore in ? Do not include
freshwater trips or trips where a paid captain or
crew helped locate and catch fish.

No private boat recreational saltwater fishing in
last 12 months
Go to Household
Member 2

No private boat recreational saltwater fishing in
last 12 months
Go to Household
Member 3

No private boat recreational saltwater fishing in
last 12 months
Go to Household
Member 4

Number of days in January and February
of 2015

Number of days in January and February
of 2015

Number of days in January and February
of 2015

Total number of days in last 12 months,
including Jan and Feb

FEBRUARY 2015
S
3
10
17
24
31

Please think only about recreational saltwater
fishing in .

No shore recreational saltwater fishing in last
12 months
Go to question 16

5 years or more

Rarely

Please think only about recreational saltwater
fishing in .

If you have more household members,
continue to household member 2.
When you have completed for ALL household
members, please return your survey to Gallup
in the enclosed postage paid envelope.

Total number of days in last 12 months,
including Jan and Feb
If you have more household members,
continue to household member 3.

Total number of days in last 12 months,
including Jan and Feb
If you have more household members,
continue to household member 4
on the back.