Farmer Registration

Farmer ID
First Name
Last Name
Father's Name
Phone Number
Gender	Male Female
Village
Household Status	Household head Spouse of household head Child of household head

How many acres of land do you own?
Top 3 crops	Maize Beans Peas Wheat Cassava Irish potatoes Groundnuts Sorghum Rice Millet Coffee Bananas Barley Cotton Other
Top 2 types of livestock	Cattle Goats Chickens Turkeys Donkeys Sheep Pigs Rabbits
Top 3 info needs	Market prices Market opportunities Weather Planting/garden prep Pest/disease management Soil management Harvesting/PHH Farming as a business Livestock rearing Health Education
If other, please specify

What is the main roof material of your house?	Thatch/straw Iron sheet/tin Cement/other
What is the main material of the wall of your house?	Unburnt bricks Burnt bricks with mud/mud poles Burnt bricks with cement
How many children under 11 live in your house?
What is the education level of the head of your household?	No grade completed Primary O level A level Certificate Graduate
What type of fuel does your household primarily use for cooking?	Firewood Charcoal Paraffin
Does your household own a TV/radio/cassette?	Yes No
Do you have a mosquito net in your household?	Yes No
Does every member of your household including children have at least two sets of clothes?	Yes No
Does every member of your household including children have at least one pair of shoes?	Yes No
Does anyone in your household own any jewelry/watch?	Yes No