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REGION REGION I-IVB IVA V VI VII VIII IX X XI XII XIII ARMM
PROVINCE
MUNICIPALITY
BARANGAY
FIRST NAME
MIDDLE NAME
LAST NAME
AGE
GENDER GENDER MALE FEMALE
CIVIL STATUS STATUS SINGLE MARRIED WIDOW SEPARATED
NUMBER OF CHILDREN (Age 10 below)
NUMBER OF CHILDREN (Age 11 above)
YEARS OF STAY IN BARANGAY
TYPE OF FARMER TYPE OWNER CARE TAKER RENTER
COCONUT HECTARES
NUMBER OF PRODUCTIVE COCONUT TREES
NUMBER OF UNPRODUCTIVE COCONUT TREES
NUMBER OF COCONUTS PRODUCED EVERY HARVEST
SOURCE OF PLANTING MATERIALS SOURCE SELF PCA LGU NURSERY
TYPE OF COCONUT FARM TYPE PLAIN COASTAL WATER LANDS MOUNTAINOUS
APPLYING FERTILIZERS? APPLY YES NO
TYPE OF FERTILIZER TYPE ORGANIC COMMERCIAL
COCONUT PRODUCT PRODUCT WHOLE NUT MEAT COPRA OTHERS
METHOD OF SELLING METHOD BROUGHT TO MARKET COOPERATIVE COPRA BUYER/TRADER
IF BROUGHT TO MARKET MARKET LOCAL / NEAR MARKET TRANSPORTED
IF THROUGH COPRA BUYER/TRADER BUYER/TRADER LOCAL CONSUMPTION TRANSPORTED TO OTHER PLACES
IS YOUR COCONUTS SICK/INFESTED? INFESTED YES NO
WHAT ARE THE SYMPTOMS Kaunti ang bunga Maliliit ang bunga Walang bunga Paninilaw ng lahat ng dahon Pananatili ng ginit kahit matanda na ang palapa Pangingitim ng dahon Kulay kape ang talbos (nanunuyo ang talbos) Pagkaubos ng dahon, tingting ang natitira Pagkaputol ng ilang dahon na iba't ibang sukat Pagkabulok ng talbos
ARE YOU FAMILIAR WITH CADANG CADANG? FAMILIAR YES NO
WHO INFORMED YOU ABOUT CADANG CADANG Kapwa magsasaka/magniniyog PCA sa pamamagitan ng CDO o ibang kawani DA sa pamamagitan ng Agric. Technician Opisyal ng barangay Media (Radio, TV, Pahayagan)
HOW MANY TREES HAVE CADANG CADANG
HAVE YOU DONE SOMETHING TO CONTROL CADANG CADANG DONE YES NO
WHAT KIND OF TREATMENTS HAVE YOU DONE Pinutol ang maysakit na puno Sinunog ang apektadong parte ng puno Iba pang paraan
OTHER TREATMENTS
NAME OF INTERVIEWER
Date of Interview ...
