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ANALYSIS
 
OF
 
THE
 
INTEGRATION
 
OF
 
MSES
 
IN
 
VALUE
 
CHAINS:
 
microREPORT #72
 
A
PPENDIX
D:
 
Q
UESTIONNAIRE
 
July 2006This publication was produced for the United States Agency for International Development by the Louis Berger Group,Inc. It was prepared by Shehnaz Atcha (The Louis Berger Group, Inc.), Elizabeth Dunn (Impact LLC, subcontractor toACDI/VOCA), David Bloom (Harvard University, subcontractor to Louis Berger Group), Banu Akin (ACDI/VOCA),Phillip Church (DevTech, subcontractor to Louis Berger Group), and Shand Evans (The Louis Berger Group, Inc.)under the Accelerated Microenterprise Advancement Project Business Development Services Knowledge and PracticeTask Order.
 
 
United States Agency for International Development FINAL Accelerated Micro Enterprise Advancement Project—Vegetable Farmer Survey Tanzania 16 OCT 2006
 
Control Number |___|___|___|___|
1of 33There are two types of instructions:
1.
 
Those in the gray boxes are directions for the interviewer and should
NOT
be read out loud.2. Those that are in white boxes should be
READ
out loud1. Respondent Name: ________________________________________ Questions 2 and 3 are for
Non-Members
in wave 1 and higher only, the go to questions 7.2. Adapted Control Number |____|____|____|____| - |____| (except Wave 0)3.
 
Name of Referrer: _______________________________________ Questions 4 – 6 are for
Members
only, then go to question 7.4. Region: 1. Arusha2. Moshi3. Lushoto |____|5.
 
Association: 1. Lishe Trust2. ULU3. Kimnyaki4. Midawe5. Enaboishu6. Machame 17. Machame 28. Lyamungo |____|6.
 
Club: ________________________________________________ 7. Sex of Respondent: 1. Male2. Female |____|8. Respondent Household Address/Directions: __________________________________________________________________________ 9. Village:__________________________________________________________ 10. Ward:__________________________________________________________ 11. Telephone number: __________________________________________________________ 12. Location: 1. Urban2. Rural |____|13. If 12 = 2 - Rural, estimate distance from farm to nearest trading center or town.1. Less than 3 km2. 3 km – 6km3. Above 6 km |____|
 
United States Agency for International Development FINAL Accelerated Micro Enterprise Advancement Project—Vegetable Farmer Survey Tanzania 16 OCT 2006
 
Control Number |___|___|___|___|
2of 33
14. Map of Respondent Location15. Date of Interview: (day/month/year) |___|___|/|___|___|/|___|___|16. INTERVIEW START TIME: |____|____|:|____|____|Use the 24 hour clock, for example: at 3:30 in the afternoon, use 15:3017. Name of Interviewer (Enumerator):__________________________________ 18. Comments on interview (rescheduled interview, interruptions, etc.) __________________________________________________________________________________  __________________________________________________________________ To be completed at the time of data entry]:19. Data Entry Person Name: ___________________________________ 
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