Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Town of Benson ADA Transition Plan Public Survey 2022

  1. Town of Benson ADA Transition Plan Public Survey 2022

    The Town of Benson is conducting an Americans with Disabilities Act Self-Evaluation and Transition Plan to ensure inclusion and access for people with disabilities.

    Your feedback will help the Town of Benson develop an ADA Transition Plan that will guide the planning of future pedestrian facility improvements. The Town welcomes public comment regarding accessibility of pedestrian facilities and Town-owned facilities. Public comments are accepted at Board of Commissioners meetings, held on the second Tuesday and fourth Thursday of each month.

  2. Question 1 (select one)*

    On a scale of 1 to 5 with 1 being “Very Poor” and 5 being “Very Good”, how would you rank the overall accessibility of Benson's pedestrian facilities?

  3. Question 2 (select one) *

    Which should be the highest priority to improve pedestrian access within the Town of Benson?

  4. Question 3 (select one)*

    What pedestrian facilities do you think require the most improvements?

  5. Question 4 (select one) *

    What barriers do you think are limiting access the most?

  6. Please list any specific areas that you feel are barriers to pedestrian accessibility.

  7. Question 6

    Do you think there are areas where ADA and disability sensitivity training are needed?

  8. If you answered YES to Question 6 — what suggestions do you have?

  9. Question 7 (select all that apply)

    I am or are related to an individual that has functional needs or disabilities affecting:

  10. If you answered OTHER to Question 7 — please list disability. 

  11. Question 8 *

    Are you a Benson resident (residing inside Town limits)? 

  12. Question 9 *

    What is your age?

  13. Question 10

    Would you like to be contacted by a town staff member?

  14. If you answered YES to Question 10 — please provide your name, phone number and/or email address.


    All responses must be received by September 30, 2022. If completing a hard copy survey, please submit to Town Hall at 303 E. Church Street. Please direct questions to Interim Town Manager Kim Pickett at 919-894-3553 or 

  16. Leave This Blank:

  17. This field is not part of the form submission.