Survey Form – CPROT 4205

PROFILE OF THE FARMER

Name: _________________________________________
Address: _____________________________________
Cellphone number: __________________________
Age: _________________________________________
Civil status: _________________________________
Name of spouse: ______________________________
Number of years in farming: _________________
Educational background:
LEVEL NAME OF SCHOOL YEAR ATTENDED
Elementary
Secondary
Tertiary

FARM INFORMATION
Farm size: _____________________________________________
Crops planted: _______________________________________
Variety/varieties planted: ____________________________
Number of croppings/year: ___________________________
SURVEY QUESTIONS
1. Do you observe insect pests in your farm? If yes, what are these?
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2. Aside from insect pests, do you observe other insects or any other arthropods?
What are these?
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3. How do you manage the insect pests? Do you monitor pest population before
application of any intervention to manage the insect pests?
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4. Do you use insecticides in the management of the insect pests?

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5. What type of insecticide formulation do you usually use?

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6. What are the brand names of insecticides that you use?

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 7. Do you practice mixing or cocktail of insecticides?
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8. Why do you use these brand names? Are they effective?

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9. Where do you buy these insecticides?

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10. Do you follow the recommended rate of the insecticide as indicated in the label?

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11. Do you strictly follow the directions for use indicated in the label of the
insecticide?
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12. How do you apply the insecticides? What equipment do you use?

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13. When do you apply the insecticides?
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14. How frequent do you apply the insecticides?

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15. How much do you spend for insecticides per cropping?

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16. What is the percentage cost of the insecticides you use in total production?

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17. Does someone influence you in choosing the insecticide to use?

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18. Where do you store the insecticides/pesticides?

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19. Where do you dispose of the used pesticide containers and the unused or
excess insecticide during application?
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20. Do you use protective gears/clothing when applying /handling insecticides?

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21. Are you aware of the symbols indicated in the label of the insecticide?
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22. Are you aware of the meaning of the color band in the insecticide label?

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23. Are you aware of the toxicity category of the insecticide you are using?
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24. Do you suffer any kind of illness related to insecticide use?

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25. Do you employ any other means/methods to manage the insect pests of your
crop? If so, what are these?
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Signature over Printed Name of the Farmer

Surveyed by:

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