Farmers Market Customer Satisfaction and Veg-U-Cation Questionnaire 8-4-2020

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery - AMS

Farmers Market Customer Satisfaction and Veg-U-Cation Questionnaire 8-4-2020

OMB: 0581-0269

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Farmers Market Customer Satisfaction and Veg-U-Cation Questionnaire

OMB No. 0581-0229




1. Are you visiting the market directly from:

  • USDA workplace

  • DC workplace

  • Other federal employee workplace

  • Tourist

  • Local residence

  • Other



  1. In What state do you live? If outside of the United States list your Country of residence.

    • Drop down list (For Paper Write State Name or Initials)

District of Columbia

If in District of Columbia, which ward?

____1 ____2 ____3 ___4

____5 ____6 ____7 ___8



  1. How did you find out about the USDA Farmers Market? (Choose one)

____Word of mouth (from friend, family member, coworker)

____Read an article online or in print

____On social media (choose one)

___Instagram ___Flickr

___Facebook ___USDA Website

___Twitter ___ Yelp

_____Stumbled upon it by accident

_____Saw poster, postcard, or other print advertisement

_____Recommended by hotel, tour guide, or tourism agency

_____Other, please specify: ______________________


  1. Roughly how much money did you spend at the market today?

  • $0

  • $1 to $25

  • $26 to $50

  • $51 to $75

  • $76 to 100

  • $101 or more


  1. What type of products did you purchase at the market today?

(select all that apply)

    • Produce

    • Frozen Meat

    • Dairy

    • Eggs

    • Prepared foods (Ready to Eat Breakfast / Lunch)

    • Baked goods

    • Beverages

    • Flowers/plants/herbs

    • Other (Please Specify)_________________

    • Nothing purchased


  1. Which of the following best describes why you visit the USDA Farmers Market?

(select all that apply)


    • Quality or freshness of products

    • Convenience to where I live or work

    • Ambiance & Social Atmosphere

    • Entertainment & Special Events

    • VegU Presentation

    • Other (please specify)


1.What was the fruit or vegetable featured at VegU-cation today? ______________________________

2. Have you eaten this fruit or vegetable before today? ____Yes ____No

3. Have you ever prepared a dish that included this fruit or vegetable? ____Yes ____No



4. Did you purchase the featured fruit or vegetable at today’s farmers market? (Choose One)


____Yes, I purchased it today at the market

____Not yet, but I plan to purchase it today at the market

____ No, I already have it at home

____I would have, but I could not find it to purchase.

____I will purchase it at my local farmers market and/or grocery store

____ No, I am not interested in purchasing the item at all

5. What information shared during today’s class was most useful to you?

(Please rank each of the following items in order of importance with #1 being the most important object to #5 being the least important object.)

____How to pick the fruit or vegetable

____How to store the fruit or vegetable ____How to prepare the fruit or vegetable


____ How to grow the fruit or vegetable

____Nutritional information about the fruit or

vegetable


6. Overall, how would you rate the quality of today’s presentation?

____Poor ____Fair ____Good ____Very Good ____Excellent

7. How likely are you to attend another class?

____Unlikely ____Likely ____Very likely

8.Share your feedback. Have suggestions to improve VegU-cation?

__________________________________________________________________________________________







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 0581-0229.  The time required to complete this information collection is estimated to average .08 hours 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. 

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected].
















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