FM Manager (for & not-for-profit), Farms (Direct Mkting)

Nutrition Assistance in Farmers Markets: Understanding Shopping Patterns

FM Appendix B6 DM farmersurvey screen shots 11-7-13

FM Manager (for & not-for-profit), Farms (Direct Mkting)

OMB: 0584-0564

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APPENDIX B6: DIRECT MARKETING FARMER WEB SURVEY SCREENSHOTS: ENGLISH
NOTE: These screenshots are illustrative. The entire survey will be programmed similarly.

ID Number: _____________
OMB Number: 0584.NEW
Expiration Date: XX/XX/20XX
Public reporting burden for this collection of information is estimated to average 25 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. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number.

This section includes questions from the Direct Marketing Farmer survey.
Click Next to continue.

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1. Do you farm full- or part-time?
Full-time
Part-time
Not applicable (provide administrative or non-administrative related services)

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APPENDIX B6: DIRECT MARKETING FARMER WEB SURVEY SCREENSHOTS: ENGLISH

2. How long have you been farming?
Years

Months
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B3. For each of the following farm products, did you sell it always, sometimes, or
never between October 2010 and September 2011?

Always

Sometimes

Fruits
Vegetables
Milk
Cheese
Other Dairy Products
Fish or Seafood
Breads or Rolls
Meat or Poultry
Other Baked Goods
Prepared Foods
Juice or Cider
Non-food Items (Plants, Crafts, etc.)
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2

Never

APPENDIX B6: DIRECT MARKETING FARMER WEB SURVEY SCREENSHOTS: ENGLISH

B4. Between October 2010 and September 2011, what was the total sale from farm
products from all outlets?

Total Sales $

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File Modified2011-09-26
File Created2011-07-13

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