Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697705787617.pdf (Dominica)
f ARMJER PROFKLJE AGRlCUL TURAL REGION: ........................... ,.

.............

., ....................... .

OFFICER'S NAMJE: ......................................................................................... .

DATJE Of COLJECTJON: {DD/MM/YY~ ..............

I ............

.

!

.............. .


f ARMER'S PHOTO Farmer Bio-Data Name: Nationality: Surname: Aliases: National Farmer Code /Produce Seller's Licence: Farming Activity Full-Time: Part-Time: Farming Experience: Farm Business Name: Legal Status: Gender?

Male: Female: Head of Household?


Yes: No: Date of Birth: Address: Telephone Number(s): E-mail Address: Education Level: Age: Main Source of Income: Off-farm Employment: Years of Employment: Spouse/Companion Name: Marital status: Telephone#: Age: Education Level: Employment (other than farm): Number of children: Age of each child Education level of each child Total number of dependents Children: Others: Number of children working On-Farm?
FT: PT: Off-Farm: Farm Profile Closest Village/Town: Agro-Tourism based: j GPS Co-ordinates: Agro-processing based: Organic Status: Organic: Non-organic: Semi-organic: Total Farm Acreage: Main Location/Centre of farming activity: No.

of other Plots: Plot Number Location of Plot Size of Plot Tenure (self-owned, rented, family-owned.

squatted.

communal etc): Percentage under use Land use (crop.
livestock, mixed) Cropping System (mixed or Pure Stand) Main Crops Main Livestock Organic/Non-organic Percentage under Fallow Percentage under Pasture Percentage Forest Feeder Road Access (Y /N) Farm Access Road (Y /N) Use of Machinery (Y/N) Water Availability On-Farm Irrigation: Yes ................ No ................. .
Plot Number Location of Plot Rain fed (Y /N) Irrigation (Y /N) Source of water Private or Public System Months of availability Storage Capacity Available (Gallons) Cost of Water Land and Soils Plot Number Location of Plot Topography~"'"'' Drainage (Good/Bad) Soil Type'"''"'::': Soil Erosion Present (Y /N) Wind Erosion (Y /N) Soil Conservation Measures (YIN) l': Cropping System: MC-Mixed Cropping or PS-Pure Stand ~"" Livestock Production System: I-Intensive.
SI-Semi-Intensive or NI-Non-intensive '"'"''' Topography: F-Flat.

GS-Gentle Slope.

NS- Not so Steep.

S-Steep.

VS-Very Steep etc.

,.,~"'""Soil Type: C-Clay, S-Sand.

SC-Sandy Clay, SltC-Silty Clay, CL-Clayey Loam.

L-Loam.

SL-Silty Loam.

and LS-Loamy Sand.

Farm Labour Total Number of Labourers: Local Foreign Family Hired Other Daily Wkly Mthly Part- time Tourist/ Volunteer Cote Main Type(.../) Number Wages (rate) Type of Work Hours Availability'~ No.
of Labourers Needed Presently Availability"': RA - Readily Available, A- Available.

NRA-Not Readily Available.

Not Available Road Access Plot Number Location of Plot Main/Feeder Road (Y /N) Distance from Farm Surface Type Surface Condition Drainage Condition Farm Road Access?

(YIN) Length of Farm Access Road (Feet) Surface Type Surface Condition Drainage Condition Farm Buildings No.

of Farm Buildings: ..................... .


Type Plot Number Number Dimensions Age Use Condition (Good/Fair/ Bad) Farm House, Storeroom.

Shed, Animal Unit, Abattoir, Dryer (solar), Dryer (Fire), any other.

Machinery, Farm Vehicles, Small Equipment and Tools Type Name/Model Serial No ./Inventory Code Quantity Age Condition Replacement (Y/N) Greenhouses No.

of Greenhouses: ................... .


Greenhouse Number/Code Dimension Age Condition Type of Covering System of Production Main Crops (Organic/Non- Grown Crops per Year organic) Annual Input Use Input/Material Type/Brand Organic/Non- organic Formulation Amount Purchased Amount Used Market Availability Market/Exporter"' Crop Type/ Location Frequency Average local Regional Extra- Regional Quantity Average/ Monthly I r- "'Hucksters.

Supermarkets.

Roseau Market.

Portsmouth Market.

Restaurants.


Hotels, Ross University and other.

Farmer Assistance (2011) Reason for Assistance (Project.

Storm Loss.

Drought Loss.

Disease etc.)

Type of Assistance Received (Input.

Monetary.

Technical Information etc.)

Amount Received Monetary Value Was assistance used on time?

(Y/N) Was assistance used on farm?

(YIN) Off-Farm Activities Group/Organization No.


of Years Involved Position (s) Held Time spent for Organization (Monthly) If you are not a member of a farmers' organization state reasons why: Would you mind being in a farmers-' Group/Organization?

Yes No: List out your main constraints in order of priority: Farmer's Signature: ................................................................... .

Officer's Signature: ................................................................... .
Farm Crop Inventory No.

of Types of Crops: ...................... .

Plot Number Crop Variety Value($) Amount Marketed in 2010 (lbs) Amount Marketed to Date 2011 (lbs) ·Value ($) Private Consumption (lbs) Wastage (lbs) : Organic Production (Yes/No) , Amount Planted Time Planted Projected Harvest Date Projected Yield (lbs) Acreage No.

of Plants : .. ' - " I ·' j<.· '.'

Farm Livestock Inventory No.

of Types of Livestock: .............................. .
Broilers Breeding Stock Fatteners Animal Category/Type Breed If Layers - - I adult Percentage Laying Flock Eggs Collected Daily (dzs) Young Adults Young Adults Young Live Meat Eggs Eggs Meat (lbs) Eggs Meat (lbs) M,i F M F M F M F Av Feed Consumed Monthly Monthly Sales ($) Private Consumption Waste