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If you have more than one vehicle, fill in both columns.
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If you have more than two vehicles, pick the two you t
' drive most often.
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13. VEHICLE NUMBER ONE
a. What year is your
i
vehicle? iF
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F,
b. Place an "X" in the r.
appropriate box.
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(1) Y' General Motors
(2) ? Ford
(3) ? Chrysler
(4) ? American Motors
(5) ? Foreign Make
14. VEHICLE NUMBER TWO
a. What year is your
vehicle?
73 k
b. Place an "X" in the
appropriate box.
(1) X
(2) M
(3)
(4) 7
(5) L,
15. JOE` FE2 K0 '_
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What is the name of the county you live in?
16. What is your gender? Place an "X" in the
correct box.
X! Female
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1 Male
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17. Are you married at the present time? Place
an "X" in the correct box.
n X Yes r
?'I No
18. Which phrase best describes why you are
taking this course? Place an "X" in the correct box.
Employee safety training
Court referral - traffic ticket I
Civic group program
Other, please specify i
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