MBTA System Orientation Training Questionnaire
If you are interested in attending or learning more about the MBTA’S system orientation training, please complete the following questionnaire.
Completed forms can be sent to
Or:
The Department of System-Wide Accessibility
Attn: System Orientation
MBTA
10 Park Plaza, #4470
Boston, MA 02116
Section 1: General Information
- Today’s Date:______
- Name:______
- D.O.B.:______
- Address:______
- City/State/Zip:______
- Phone:______
- E-mail:______
- Do you travel with a service animal?______
- Do you travel with a Personal Care Attendant (PCA)?______
- Do you use any of the following mobility aids? (circle or underline all that apply) wheelchair/scooter, walker, cane, crutches, other (specify)
Section 2: Transit Use
- Do you currently travel using the MBTA’s fixed-route system (buses, trains, trolleys)? Yes_____No______
- How frequently do you travel using the MBTA’s fixed route system (buses, trains, trolleys)? (Circle or underline your answer) Every day, 2-3x/week, 1x/week, 1-3x/month, less than 1x/month
- Are you currently a registered RIDE (paratransit) user? Yes_____No______
- If so, how often do you take The RIDE? Circle or underline your answer) Every day, 2-3x/week, 1x/week, 1-3x/month, less than 1x/month
- How often do you rely on family members and/or friends for transportation? Circle or underline your answer) Every day, 2-3x/week, 1x/week, 1-3x/month, less than 1x/month
- Do you currently have a Senior CharlieCard, Blind Access CharlieCard or Transportation Access Pass (Disability CharlieCard)? Yes_____No______
- Do you feel that a program that familiarizes you with the MBTA’s accessible services would encourage you to take the fixed-route system (buses, trains and trolleys) for most of your trips in the community? Yes_____No______
- If there were a program designed to teach you how to use the bus or train to get to school, work, or other community activities, would you be interested in participating in such a program? Yes_____No______
Section 3: Transportation Barriers
- What are some of the barriers that make it difficult for you to use the MBTA’s fixed-route system (buses, trains and trolleys)?______
- If these barriers were no longer barriers, would you be more likely to use the fixed-route system (buses, trains and trolleys) for most of your trips in the community? Yes_____No______
Section 4: Reasonable Accommodations
A portion of this training will occur in a classroom setting during which participants will view a PowerPoint presentation and lean general information about the MBTA’s fixed route system including how to read bus schedules and subway maps. The training also has a hands-on portion during which participants will experience boarding and exiting an MBTA bus and subway vehicle, operating a farebox and fare vending machine. Portions of the training may occur outdoors, even during inclement weather.
All locations used during this orientation are accessible to people with disabilities. The MBTA is committed to ensuring that all attendees are able to participate fully by providing reasonable accommodations as necessary. For example, accommodations may include: handouts in large print/Braille/audio, American Sign Language interpreters, assistive listening devices, etc.
- Will you need a reasonable accommodation to fully participate? Yes_____No______
- Please specify: ______
Section 5: Class Preference
Please select the type of Orientation training you would like to attend:
___General Orientation: In addition to a general overview of the MBTA’s accessible services, training provides a brief overview of access features that may be used by customers who have a variety of disabilities.
___Orientation for Customers with Visual Impairments: In addition to a general overview of the MBTA’s accessible services, customers will have an opportunity to participate in a training specifically geared to customers with visual impairments.
To request this form in an alternate format or language, email or call 617-222-5237.
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