CSA Enterprise Directory form OMB NO. 0581-0169
[current
year] USDA
Directory of Community Supported Agriculture (CSA)
Enterprises
=================================================================================
Questions
1 – 6 are designed to appear in subsequent years of the
Directory and will be visible only to those who filled the Directory
form in the previous year or information is already available from
another source.
These questions are included for the OMB
approval.
(Only
managers/ representatives from previous year’s Directory see
this question)
[Q1]
Will [name
of the CSA enterprise from previous year’s Directory]
operate as a “community-supported agriculture (CSA)”
farm or multi-farm enterprise” anytime in [current
year]?
O
1- Yes => Go to Q2 (Still manager/ rep)
O 2- No
=>
Skip to Q3 (Manager/ rep of another CSA enterprise )
O 3-
Do not know => Go to Q2 (Still manager/
rep)
---------------------------------------------------------------------------------------------------------------------------------------------------------------
[Q2]
According to the USDA CSA Enterprise Directory, you were either a
manager or a representative of [name
of the CSA enterprise from previous year’s Directory]
in previous Directory. Are you still a manager or a representative
of this CSA enterprise in [current
year]?
O
1- Yes
=> If Yes (open) in Q1 and Yes (manager/ rep)
in Q2 => Skip to Q6 (Correct CSA enterprise name?)
=>
If Don’t know (if open) in Q1 and Yes (manager/ rep) in Q2 =>
Go to additional message below
O 2- No => Go to Q3
(Manager/ rep of another CSA enterprise
)
---------------------------------------------------------------------------------------------------------------------------------------------------------------
ADDITIONAL
MESSAGE
Only respondents who “Don’t
know”(if CSA enterprise open) in Q1 and Yes (are
managers/representatives) in Q2 will see the below message
Based
on your responses, we see that you are still the manager or the
representative of [name
of the CSA enterprise from previous year’s Directory],
but you do not know if it is going to operate as a CSA enterprise
any time in [current year]. This Directory will be available for
online updating throughout the year, so please update the
information for this CSA enterprise if it opens sometime in
[current
year].
=>
Exit the current year USDA Directory
update
---------------------------------------------------------------------------------------------------------------------------------------------------------------
[Q3]
Are you a manager or a representative of another CSA enterprise
in [current
year]?
O
1- Yes => Go to Q4 (Willing to provide info on another CSA
enterprise)
O 2- No
=>
Exit the current year USDA Directory
update
---------------------------------------------------------------------------------------------------------------------------------------------------------------
[Q4]
Are you willing to provide information about the CSA enterprise
that you manage or represent in [current
year]?
O
1- Yes => Go to Q5 (Search engine)
O 2- No
=>
Exit the current year USDA Directory
update
============================================================================================
(Question
visible only to those who came through the public web site or who
came through the link but manage different CSA enterprise)
SEARCH
ENGINE
[Q5] Please type in the correct official
name of the CSA enterprise that you manage or represent.
As
you start typing, CSA enterprises with the same or similar name(s)
may appear and you may choose the proper CSA enterprise name by
clicking on the “update” link in the right column.
Should there be a spelling mistake in the name of the
CSA enterprise listed, but you are sure (by checking the location
address) that this is the CSA enterprise you manage or represent,
you will have an opportunity to correct the spelling of the
official CSA enterprise name.
For your convenience, you
may also search the list by typing in the zip code of the LOCATION
of the CSA enterprise (not the zip code for the mailing address, as
it might be different).
CSA
enterprise name or zipcode:……………………
Displayed CSA enterprise names |
Location street |
City |
State |
Zip code |
Update |
Xa |
|
Ka |
AZ |
|
Update => Go to Q6 (Is the name correct?) |
Xb |
|
Le |
OK |
|
Update => Go to Q6 (Is the name correct?) |
Xc |
|
Mw |
RI |
|
Update => Go to Q6 (Is the name correct?) |
aXa |
|
Kl |
AZ |
|
Update => Go to Q6 (Is the name correct?) |
bXb |
|
Lm |
OK |
|
Update => Go to Q6 (Is the name correct?) |
cXc |
|
Mg |
RI |
|
Update => Go to Q6 (Is the name correct?) |
If
the name of the CSA enterprise that you manage or represent is not
listed, please click
here
to continue. =>
Skip to Q7 (Type correct
name)
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(Question
visible only to those who came through the public web site AND
clicked on “update” in the table in Q6)
[NameCheck]
Is “[name
of the CSA enterprise from previous year’s Directory]”
the correct official
name of your CSA enterprise?
O
1- Yes. If yes, this information will appear in the [current
year]
USDA CSA Enterprise Directory.
=> Skip to Q8 (CSA
enterprise definition)
O 2- No => Go to Q7
(Provide correct
name)
============================================================================================
CSA enterprise information
(New-comers
and “No” [i.e., incorrect name] in Q5 or in Q6 see this
question)
[CorrectedName]
Please type in the correct official
name of the CSA enterprise that you manage or represent. The name
that you provide here will appear in the [current
year]
USDA CSA Enterprise
Directory.
…………………………………………………………
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(Everyone
sees this question)
[QualifiedMarket]
For the purposes of this Directory, a “community- supported
agriculture (CSA) enterprise” is defined as a farm or
network/ association of multiple farms, that offer consumers
regular (usually weekly) deliveries of locally-grown farm products
during one or more harvest season(s) on a subscription or
membership basis. Customers have access to a selected share or
range of farm products offered by a single farm or group of farmers
based on partial or total advance payment of a subscription or
membership fee.
Does this enterprise qualify as a CSA
enterprise as defined above?
O
1- Yes=> Go to Q9 (Person’s contact info)
O 2-
No => Exit the [current year] USDA Directory
update
============================================================================================
Information
listed in this section will not
be published in
the
[current
year]
USDA CSA Enterprise Directory. This is for internal purposes only
so that we can maintain data clarity and accuracy. This information
will be kept confidential.
Please
provide contact information of person completing this form:
(Information
below filled with [current year] data for those that access the
form via the unique link and are still managers of their CSA
enterprises)
[Contact_Name]
Name:
……………………
[Contact_Email]
Email
address:
……………………
[Contact_Phone]
Contact
(phone) number:
……………………
[Contact_relation]
What is your primary
relationship with this CSA enterprise?
O
1- CSA manager/ owner
O 2- Contact person / public
liaison for this CSA enterprise
O 3- Head of CSA enterprise
association
O 4- CSA enterprise employee
O 5- CSA
shareholder
O 6- Other, [Contact_relation_Other]
please
specify: ……………………
===============================================================================================
All
information you provide from this point forward will
be published in the [current
year]
USDA CSA Enterprise Directory.
Address
of the headquarters of your CSA enterprise:
(Information
below filled with previous-year data for those that access the form
via the unique link and are still managers of their CSA
enterprises)
[HQ__ST]
Street
name and number or P.O. Box number:
……………………
[HQ__City]
City:
……………………(required)
[HQ__State]
State:
……………… (A drop-down menu)
(required)
[HQ_Zip]
5-digit
ZIP Code:
……………………
(only 5 digits allowed)
Please
provide the contact information for your business address for your
CSA enterprise (when available):
(Information
below filled with [current year] data for those that access the
form via the unique link and are still managers of their CSA
enterprises)
[_] Name, email address and phone the
same as in contact information already provided.
[If the
box checked, information will be automatically filled
in]
[CSA_ManagerName]
CSA
enterprise manager’s name:
……………………
[CSA_Email]
CSA
enterprise email address:
……………………
[CSA_Phone]
CSA
enterprise phone number:
……………………
[CSA_Website]
CSA
enterprise website address:
……………………
[CSA_Facebook]
CSA
enterprise Facebook page:
……………………
[Like]
[CSA_Twitter]
CSA
enterprise Twitter address:
……………………
[CSA_Blog]
CSA
enterprise blog address:
……………………
CSA
enterprise contact information on other social media:
……………………
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How
long has this CSA enterprise been in continuous operation?
O
This is the first year
O 2 - 3 years
O 4 - 5
years
O 6 - 10 years
O 11 - 15 years
O 16 -
20 years
O 21 years or longer
O Do not know
During
which months will your CSA enterprise have products available to
its consumer members in [current
year]?
If not “Year round” or “Not sure yet”,
please select all that apply.
[_]
Year round
[_] January
[_] February
[_]
March
[_] April
[_] May
[_] June
[_]
July
[_] August
[_] September
[_] October
[_]
November
[_] December
[_] Not sure yet
How
many individual farms will supply products to your CSA in [current
year]?
Please
enter only numbers in the box; no commas, periods, letters, or
symbols.
______________
farms [numbers only, range 1 – 100]
Information about products and their availability
Which
farm products and other items will be included in member shares or
available for purchase from your CSA enterprise in [current
year]?
Please select all that apply.
[_]
Baked goods: breads, pies, etc.
[_] Canned or preserved
fruits/ vegetables: jams, jellies, preserves, salsas, pickles,
dried fruit, etc.
[_] Coffee and/or tea
[_] Cut
flowers
[_] Dairy products: milk, cheese, etc.
[_]
Dry beans
[_] Eggs
[_] Fish and/or seafood => Go
to Q17 (willing to provide list of fish and seafood)
[_]
Fresh and/or dried herbs
[_] Fresh fruits => Go to Q19
(willing to provide list of fruits)
[_] Fresh vegetables =>
Go to Q21 (willing to provide list of vegetables)
[_] Grains
and/or flour
[_] Honey
[_] Juices and/or
non-alcoholic ciders
[_] Maple syrup and/or maple
products
[_] Mushrooms
[_] Nuts
[_] Pet
food
[_] Poultry/ fowl meat and products => Go to Q23
(willing to provide list of poultry meat)
[_] Red and other
non-poultry meat and products=> Go to Q25 (willing to provide
list of red/ non-poultry meat)
[_] Soap and/or body care
products
[_] Tofu and/or non-animal protein
[_] Wild
harvested forest products: mushrooms, medicinal herbs, edible
fruits and nuts, etc.
[_] Wine, spirits, beer, hard
cider
[_] Other, please specify: ……………………
=>
All other selections will skip to Q27 (organic
certification)
___________________________________________________________________________________________
Only
those that selected fish/ seafood in Q16 will see this question.
Would
like to provide more specific information about the fish
and seafood
offered by your CSA enterprise so that it can appear in the
Directory?
O
Yes => Go to Q18 (fish/ seafood types)
O
No => Skip to the next specific
food type
(if selected in Q16) or to Q27 (organic certification)
Please
indicate which type of fish
and seafood
your CSA enterprise will offer to its consumer members in [current
year].
Please select all that apply.
[_]
Crab
[_] Lobster
[_] Mussels
[_] Oysters
[_]
Shrimp/prawns
[_] Salmon
[_] Trout
[_]
Tuna
[_] Other fish/ seafood, please specify:
……………………
Only
those that selected fresh fruits in Q16 will see this question.
Would
like to provide more specific information about the fruit
offered by your CSA enterprise so that it can appear in the
Directory?
O
Yes => Go to Q20 (fruit types)
O
No => Skip to the next specific
food type
(if selected in Q16) or to Q27 (organic certification)
Please
indicate which type of fresh fruit
your CSA enterprise will offer to its consumer members in [current
year].
Please select all that apply.
[_]
Apples
[_] Apricots
[_] Avocados
[_]
Blackberries, raspberries
[_] Blueberries
[_]
Cantaloupes
[_] Cherries (sweet, tart, etc.)
[_]
Cranberries
[_] Currants
[_] Dates
[_] Figs
[_]
Gooseberries
[_] Grapefruit (red, white, etc.)
[_]
Grapes (black, green, red, etc.)
[_] Honeydew melons
[_]
Kiwi
[_] Lemons, limes
[_] Mangos, papayas,
pineapples and other tropical fruit
[_] Nectarines
[_]
Oranges, clementines, mandarins, tangerines, tangelos
[_]
Peaches (yellow, white, etc.)
[_] Pears
[_]
Persimmons
[_] Plums (black, green, red, etc.)
[_]
Strawberries
[_] Watermelons
[_] Other fruit, please
specify:
……………………
Only
those that selected fresh vegetables in Q16 will see this question.
Would
you like to provide us with more specific information about the
fresh vegetables
offered by your CSA enterprise so that it can appear in the
Directory?
O
Yes => Go to Q22 (vegetables types)
O
No => Skip to the next specific
food type
(if selected in Q16) or to Q27 (organic certification)
Please
indicate which type of fresh vegetables
your CSA enterprise will offer to its consumer members in [current
year].
Please select all that apply.
[_]
Alfalfa sprouts
[_] Artichokes
[_] Arugula
[_]
Asparagus
[_] Beans (string)
[_] Beans, other (lima,
butter, etc.)
[_] Beets
[_] Bok Choy
[_]
Broccoli
[_] Broccoli rabe
[_] Broccolini/baby
broccoli
[_] Brussels sprouts
[_] Cabbage
[_]
Carrots
[_] Cauliflower
[_] Celery
[_] Collard
Greens
[_] Corn (sweet)
[_] Cucumbers
[_]
Eggplant (Italian, Japanese, etc.)
[_] Endive
[_]
Garlic
[_] Green beans
[_] Green onions/scallions
[_]
Kale
[_] Kohlrabi
[_] Leeks
[_] Lettuce
(head, leaf, etc.)
[_] Mache/lamb’s lettuce
[_]
Mixed leafy greens
[_] Mizuna
[_] Mustard Greens
[_]
Okra
[_] Onions (pearl, red, yellow, white, etc.)
[_]
Parsnips
[_] Peas
[_] Peanuts
[_] Peppers,
hot
[_] Peppers, sweet
[_] Potatoes(new, red, russet,
white, etc.)
[_] Pumpkin
[_] Radicchio
[_]
Radishes
[_] Rhubarb
[_] Rutabaga
[_]
Soybeans
[_] Shallots
[_] Spinach: baby, regular
[_]
Squash, summer: zucchini, yellow, etc.
[_] Squash, winter :
acorn, butternut, etc.
[_] Sweet potatoes
[_] Swiss
chard
[_] Tomatillos
[_] Tomatoes (cherry, grape,
etc.)
[_] Tomatoes (plum, round, etc.)
[_] Turnips
[_]
Turnip greens
[_] Other fresh vegetables, please specify:
……………………
Only
those that selected poultry/ fowl in Q16 will see this question.
Would
like to provide more specific information about the poultry/
fowl
products offered by your CSA enterprise so that it can appear in
the Directory?
O
Yes => Go to Q25 (poultry/ fowl types)
O
No => Skip to the next specific
food type
(if selected in Q16) or to Q27 (organic certification)
Please
indicate which type of poultry/
fowl
your CSA enterprise will offer to its consumer members in [current
year].
Please select all that apply.
[_]
Chicken
[_] Cornish game hens
[_] Duck
[_]
Goose
[_] Ostrich
[_] Pheasant
[_] Squab
(Pigeon)
[_] Quail
[_] Turkey
[_]
Other poultry/ fowl, please specify:
……………………
Only
those that selected (non-poultry) meat in Q16 will see this
question.
Would
like to provide more specific information about the red
and non-poultry meat
offered by your CSA enterprise so that it can appear in the
Directory?
O
Yes => Go to Q23 (non-poultry meat types)
O
No => Skip to Q27 (organic certification)
Please
indicate which type of red
and non-poultry meat
and meat products your CSA enterprise will offer to its consumer
members in [current
year].
Please select all that apply.
[_]
Beef/veal (cold cuts)
[_] Beef/veal (ground)
[_]
Beef/veal (sausage)
[_] Beef/veal (steaks, roasts)
[_]
Bison (ground)
[_] Bison (steaks, roasts)
[_] Elk
[_]
Goat
[_] Lamb (chops, roasts)
[_] Lamb (ground)
[_]
Lamb (sausage)
[_] Pork (bacon)
[_] Pork (chops,
roasts)
[_] Pork (cold cuts)
[_] Pork (ham)
[_]
Pork (sausage)
[_] Rabbit
[_] Venison
[_]
Other meat items, please specify:
……………………
------------------------------------------------------------------------------------------------------------------------------------------------------------------
All CSAs
Does
your CSA enterprise offer products certified as “organic”
by the USDA?
O
Yes
O No
Does
your CSA enterprise refer to specific types of production methods
and practices in its marketing and promotional material (including
product packages and labels)?
O
Yes => Go to Q 29 (what production practices)
O No =>
Skip to Q30 (number of shares)
Which
types of production method or practice claims will your CSA
enterprise use to market and promote its food (including product
packages and labels) in [current
year]?
Please select all that apply.
Only
check those production methods and practice claims that are used to
market/promote foods for the CSA portion of your business, not your
farm enterprise(s) as a whole.
[_]
No pesticides
[_] No antibiotics
[_] No hormones
[_] Fair Labor practices
[_] Humane treatment of
animals
[_] Pasture-raised/
free range animals
[_]
Other, please specify: ……………………
About shares
In
total, how many CSA shares/ subscriptions does your farm have in
[current
year]?
Please
enter only numbers in the box; no commas, periods, letters, or
symbols.
[NumShares]
……………………
shares/ subscriptions [the minimum number of shares: 2 –
20000] (5 digits; warning, if number higher than 20,000: “The
number of shares/ subscriptions that you provided is large. Please
verify that your answer is correct.”)
Please
indicate the type of subscription/ membership choices your CSA
enterprise is offering in [current
year].
Please select all that apply.
[_]
Full share
[_] Full and half shares
[_] Other,
please specify: ……………………
How
are the product items in your CSA share box selected? Please
select all that apply.
[_]
CSA decides product assortment of shares/delivery boxes based
entirely on supply availability; customer does not influence
product selection
[_] CSA offers separate subscription
options for specific product categories (e.g., vegetables, meat,
eggs,) that customers select at the beginning of the delivery
season
[_] CSA customers order specific items from a list of
available farm products in advance of each delivery
[_]
Other, please specify:
……………………
When
do your CSA’s shares first
become
available for purchase in [current
year]?
Month
(drop-down menu)…………..
Day
(drop-down menu)……………..
What
types of payment will be accepted by your CSA enterprise in
[current
year]?
[_]
Cash
[_]
Checks
[_]
Credit cards
[_]
SNAP benefits (Bridge cards/ EBT)[_]
Other, please specify: ........................................
Which
types of payment options does your CSA enterprise offer to its
subscribers/members? Please select all that apply.
[_]
One advance payment prior to the beginning of the delivery
season
[_]
Payments in installments
over the course of each delivery season
[_]
Reduced subscription/membership fees in exchange for labor
[_]
Reduced subscription/membership fees based on household
income
[_]
Other, please specify: ……………………
Product share pick-up and delivery
[NumOfLocation]
In [current
year],
how will your CSA enterprise deliver products to its
subscribers/members? Please select all that apply.
[_]
1- Deliver to one or more neighborhood sites that are located
close to subscribers/members => Go to Q38 (Number of delivery
locations)
[_] 2- Deliver directly to
subscribers/members’ homes (by truck or express mail) =>
Skip to Q40 (frequency of product availability)
[_]
3- Deliver to subscribers/members’ workplaces => Skip to
Q40 (frequency of product availability)
[_] 4- No
deliveries; subscribers/members pick up merchandise from CSA
farm(s) => Skip to Review
page
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Only
those who marked “Deliver to some central location(s) ...”
in Q37 will see the below question.
In
[current
year],
how many neighborhood delivery sites will your CSA enterprise use?
Please
enter only numbers in the box; no commas, periods, letters, or
symbols.
........................................
Delivery locations [numbers only, range 1 – 100]
Only
those who marked “Deliver to some central drop-off
location(s) ...” in Q37 will see the below question.
In
which cities or towns will your CSA enterprise have neighborhood
delivery sites in [current
year]?
Please type in one site at a
time.
........................................
Add
another
city/town.
============================================================================================
REVIEW PAGE
Please review your CSA enterprise information that you have just provided. If you approve the information, this is what will be displayed in the [current year] USDA CSA Enterprise Directory.
If everything is correct, please click on “Finish” button.
If
you want to make a correction in a particular section, please click
on a “Edit” link in that section.
(Respondents
will be on a loop clicking on a button and correcting one section at
a time, until they click on “Save
and finish the form” button.
[Name of the CSA enterprise from [current year] Directory] |
Edit |
Address |
Edit |
Products |
Edit |
Share size |
Edit |
Farming practices |
Edit |
=============================================================================================
THANK-YOU PAGE
Dear
CSA Manager/Representative,
Thank you for updating your
CSA enterprise
listing for the [current
year]
CSA Enterprise Directory. If
you wish to enter information about an additional CSA enterprise,
please click
here.
We greatly appreciate your participation in this very important project to help keep consumers informed about the scope of CSA enterprises, and how they can take advantage of the valuable information in this Directory to find great sources of local food in their own backyards..
If
you have any questions about the Directory itself, please contact us
at [email protected] or (202)
720-8317.
If
you update information on your CSA enterprise by XXXX,
it will appear in the [current
year]
USDA CSA Enterprise Directory by YYYY.
This means consumers will be able to find your CSA enterprise just
as the busy summer season is getting underway. CSA enterprise
listings submitted after MMMM,
but by KKKK
will be published in the Directory by LLLL.
Thank
you for updating your CSA enterprise listing for the [current
year] CSA
Enterprise Directory.
Sincerely,
Ed
Ragland
Agricultural Economist
=============================================================================================
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information, unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0169. The time required to complete this information collection is estimated to average 22 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.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
2014 CSA Directory Update Form
-
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | CSA Enterprise Directory form... OMB NO. 0581-016 |
Author | carrsadmin |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |