Mobility survey – Stephanie Square – Employees Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire. - Étape 1 sur 6NOTE : FEDERAL (DE)CONTAINMENT MEASURES This survey relates to your usual work and trip practices. The federal measures of (de)containment currently in force in our territory may be causing a change in your habits. However, the resulting work and trip practices are not representative of an usual situation. Therefore, please provide answers describing your work and trip practices before the implementation of the measures adopted in the context of the fight against the pandemic linked to the COVID-19 virus.NextPlease enter the name of the company you work for *Cabinet du Ministre-Président de la Fédération Wallonie-Bruxelles P.-Y. JeholetClifford Chance LLPNOTABELOtherSpecify: *NextJOURNEY BETWEEN YOUR HOME AND YOUR WORKPLACEHow do you usually get to your workplace? *I use different modes of transport during the week e.g. Monday: car / Tuesday: train+bicycle / etc.I use several modes of transport during my journey e.g. bike + trainCar as a driverCar as a passenger (carpooling)Motorcycle – Motor Scooter – etc.Public transport (train, tram, bus, subway)Bicycle - Scooter - etc. (with or without electrical assistance)On footIf you wish to specify your answer, please complete the field below.Where do you usually park your vehicle when you arrive at your workplace? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)CARPOOLING PRACTICEDo you usually carry with you any passenger over 18 on all or on a part of the journey to your workplace? *YesNoCharacteristics of your carpooling practiceNumber of your passengers working in the building *If you do not carry any passenger working in the building, please type 0Number of your passengers not working in the building *They may be members of your household or third parties. In both cases, only provide information for people over 18. If you do not carry with you any passenger over 18 not working in the building, please type 0 On average, how many days a week do you carry with you one or more of the passengers listed above?« Less than one day a week » « 1 day a week » « 2 days a week » « 3 days a week » « 4 days a week » « 5 days a week » « 6 days a week » « 7 days a week » Where do you usually park your Bicycle - Scooter - etc. when you arrive at your workplace? *In the parking lot of the buildingOutside the buildingOtherSpecify: *Enter the different modes of transport you use during your usual journey *Car as a driverCar as a passenger (carpooling)Motorcycle - Motor scooter - etc.Public transport (train, tram, bus, subway)Bicycle - Scooter - etc. (with or without electrical assistance)On footDuring your usual journey, do you park your vehicle in the building's parking lot? *YesNoFill in the reason why you do not park in the building's parking lot *I do not arrive at my workplace by Car or Motorcycle - Motor scooter - etc.I park in the street, near the buildingI park in another parking lot, outside the building (public parking, subscriber parking, etc.)Enter all the modes of transport you usually use during a regular workweek *Car as a driverCar as a passenger (carpooling)Motorcycle - Motor scooter - etc.Public transport (train, tram, bus, subway)Bicycle - Scooter - etc. (with or without electrical assistance)On footWhen you go to your workplace by Car or Motorcycle - Motor scooter - etc. where do you usually park? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)Given your use of the vehicle during a normal workweek, how many days per week is it parked in the parking lot of the building? *« Less than one day a week e.g. 2 days a month » « 1 day a week » « 2 days a week » « 3 days a week » « 4 days a week » « 5 days a week » « 6 days a week » « 7 days a week » PreviousNextUSE OF OTHER MODES OF TRANSPORT1>Do you sometimes use the Car as a driver or the Motorcycle - Motor scooter - etc. to get to your workplace? *YesNo, neverWhen you go to your workplace by Car or Motorcycle - Motor scooter - etc. What type of vehicle do you use? *Private vehicle or company vehicleService vehicleWarning: Do not confuse service vehicles with company cars Service vehicles: - Not assigned to a specific employee; - Can generally only be used for business travel. Company cars: - They are attributed to a specific employee and constitute a benefit in kind for the latter; - Can be used for all types of journey.When you drive to your workplace using the vehicle in question, where do you usually park it? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)Given your use of the vehicle in question, how many days per week on average is it parked in the parking lot of the building? *« Less than one day a week on average » « 1 day a week on average » « 2 days a week on average » « 3 days a week on average » « 4 days a week on average » « 5 days a week on average » « 6 days a week on average » « 7 days a week on average » Do you sometimes use the Car as a driver or the Motorcycle - Motor scooter - etc. to get to your workplace ? *YesNo, neverWhen you go to your workplace by Car or Motorcycle - Motor scooter - etc. what type of vehicle do you use? *Private vehicle or company vehicleService vehicleWarning: Do not confuse service vehicles with company cars Service vehicles: - Not assigned to a specific employee; - Can generally only be used for business travel. Company cars: - They are attributed to a specific employee and constitute a benefit in kind for the latter; - Can be used for all types of journey.When you drive to your workplace using the vehicle in question, where do you usually park it? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)Given your use of the vehicle in question, how many days per week on average is it parked in the parking lot of the building? *« Less than one day a week on average » « 1 day a week on average » « 2 days a week on average » « 3 days a week on average » « 4 days a week on average » « 5 days a week on average » « 6 days a week on average » « 7 days a week on average » Do you sometimes use the Car as a driver or the Motorcycle - Motor scooter - etc. to get to your workplace? *YesNo, neverWhen you go to your workplace by Car or Motorcycle - Motor scooter - etc. what type of vehicle do you use? *Private vehicle or company vehicleService vehicleWarning: Do not confuse service vehicles with company cars Service vehicles: - Not assigned to a specific employee; - Can generally only be used for business travel. Company cars: - They are attributed to a specific employee and constitute a benefit in kind for the latter; - Can be used for all types of journey.When you drive to your workplace using the vehicle in question, where do you usually park it? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)Given your use of the vehicle in question, how many days per week on average is it parked in the parking lot of the building? *« Less than one day a week on average » « 1 day a week on average » « 2 days a week on average » « 3 days a week on average » « 4 days a week on average » « 5 days a week on average » « 6 days a week on average » « 7 days a week on average » Do you sometimes use the Car as a driver or the Motorcycle - Motor scooter - etc. to get to your workplace? *YesNo, neverWhen you go to your workplace by Car or Motorcycle - Motor scooter - etc. what type of vehicle do you use? *Private vehicle or company vehicleService vehicleWarning: Do not confuse service vehicles with company cars Service vehicles: - Not assigned to a specific employee; - Can generally only be used for business travel. Company cars: - They are attributed to a specific employee and constitute a benefit in kind for the latter; - Can be used for all types of journey.When you drive to your workplace using the vehicle in question, where do you usually park it? *In the parking lot of the buildingIn the streetIn another parking lot, outside the building (public parking, subscriber parking, etc.)Given your use of the vehicle in question, how many days per week on average is it parked in the parking lot of the building? *« Less than one day a week on average » « 1 day a week on average » « 2 days a week on average » « 3 days a week on average » « 4 days a week on average » « 5 jours par semaine » « 6 jours par semaine » « 7 jours par semaine » BUSINESS TRAVELYou have specified that you use the building's parking lot to park your vehicle. Do you need to make business trips using the vehicle in question? *YesNoWarning: Please consider as a business trip also a journey made from your home to some job related places, without stopping at your workplace before arriving at your destination (for example, if you go from your home to some clients)How many days a week do you make business trips using the vehicle in question? *« Less than one day a week e.g. 2 days a month » « 1 day a week »« 2 days a week »« 3 days a week »« 4 days a week »« 5 days a week »« 6 days a week »« 7 days a week »Please consider a regular workweekFeatures of your business trips On the days you make business trips, how many trips do you usually make per day using the vehicle in question? *« 1 trip per day »« 2 to 3 trips a day »« 4 to 5 trips a day »« More than 5 trips a day »Specify: *When you make business trips using the vehicle in question, to which destination(s) do you usually travel to? *Brussels-Capital RegionBelgium (except BCR)AbroadYou can enter several destinationsAt what time(s) of the day do you usually travel for business with the vehicle in question? *Day (between 7am and 8pm)Evening (between 8pm and 11pm)Night (between 11pm and 7am)You can enter several periodsFor what purpose(s) do you make business trips using the vehicle in question? *Attending a meetingGetting to a building siteApproaching potential clientsSelling productsOtherYou can enter several reasonsBriefly describe the reason(s) for these business trips *Example: "I go to one of the sites of my company's production" Do you transport heavy and/or bulky equipements when travelling for work using the vehicle in question? *YesNoWhat type(s) of equipement are they? *GoodsTechnical equipmentOtherYou can enter several types of equipementBriefly describe the type(s) of equipement transported *Example: "I transport advertising material"USE OF THE BUILDING'S PARKING LOT Based on your travel practices between your home and your workplace, we conclude that you do not use, in a usual and/or frequent manner (i.e. at least 1 day per week), the building's parking lot to park a personal motor vehicle (car or motorcycle). If this statement is correct, press next. If not, please go to the previous page to modify your answers.PreviousNextOCCUPIED POSITION WITHIN THE COMPANY Fill in the title of your position. You can also briefly describe your work in the company. Title of your position *PRESENCE WITHIN THE BUILDING Enter the periods during which you are generally physically present in the building If you are teleworking or working outside the building on specific days of the week, do not enter these days. If you do not telework or do not perform work outside certain defined days of the week, refer to your employment contract to answer this question. Monday *Morning Evening Afternoon Night I am not present in the buildingTuesday *MorningEveningAfternoonNightI am not present in the buildingWednesday *MorningEveningAfternoonNightI am not present in the buildingThursday *MorningEveningAfternoonNightI am not present in the buildingFriday *MorningEveningAfternoonNightI am not present in the buildingSaturday *MorningEveningAfternoonNightI am not present in the buildingSunday *MorningEveningAfternoonNightI am not present in the buildingPLACE OF RESIDENCE By residence, we mean the place where you actually live. It may differ from your legal residence.Country of residence *BelgiumNetherlandsGermanyLuxembourgFranceOtherBy residence, we mean the place where you actually live. It may differ from your legal residence.Postal code of your place of residence *Do you have a disability recognised by the FPS Social Security - DG Disabled People? *YesNoI am involved in a procedure for the recognition of my disabilityDo you have a parking card for people with disabilities? *YesNoThe cards in question are provided by the SPF Social Security - DG Disabled PeopleOnce your disability will be recognized, will you have a parking card for people with disabilities? *YesNoI don't knowPreviousNextThank you for your kind participation! If you have any comments regarding mobility within your company or if you would like to specify one of your answers, do not hesitate to fill in the field below.PhoneSend