Center-XII

FARMING LEARNING SITE FOR AGRICULTURE (LSA) PROFILE FORM

(Individual/Private Organization/Government Institution)

Name of Farm: BARROSO INTEGRATED FARM AND TECHNICAL INSTITUTE INC.

The Owner: ___/___ Farmer/Farm Family  ______ Private Organization  _____ Government Institution

0. THE OWNER’S PROFILE

A.1 For Individual Farmer/Farm Family

Name of Applicant: RICHARD ROSS C. BARROSO

Sex: __/____ Male Date of Birth: Ethnic Origin/Tribe:

         ______ Female 09/22/1993 BISAYA

Civil Status: __/___ Single _____ Married _____ Separated _____ Widow

Home Address: Purok Paghiusa, Brgy. Poblacion, Tampakan,South Cotabato

Cellphone No.:09056438872 e-mail Address: rrbarroso199322@gmail.com

Educational Attainment: Masters Degree

RSBSA/NCFRS Registration No.:

A.2 For Private Organization/Government Institution

Name of Organization:

Registered Address:

Name of Farm Manager/In-Charge: Position/Designation:

Educational Attainment of Farm Manager/In-Charge:

Cellphone No: Landline: e-mail Address:

1. Membership in Organization of the Individual Farmer/Farm Family/Affiliations of

the Organization/Government Institution

Name of Organization Date Joined Position, if any

4-H Club 2010 President
Samahan ng Mga Kabataang 2013 president
Negosyante at Magsasaka

2. Trainings/Seminars/Workshops/Conferences attended by the Farmer/Farm

Family/Organization/Institution Farm In-Charge, Local & Foreign (Use additional

ATI-QF/PAD-48 Rev. 04 Effectivity Date: August 2, 2022

 Sheets if

necessary)

Title of Training Date Attended Name of Sponsoring Organization

 Knowledge co-creation program 2016 Japan International Cooperation
for young leaders on Agri-Eco Agency
tourism
2021 ATI
 KAMMP Online
 NCII Organic Agriculture 2022 TESDA
Production

3. Topics Delivered/Capable of Delivering as Resource Person by the Farmer/Farm

Family/Organization Farm In-Charge

No. of times
Topic Audience
delivered

B. THE FARM (For Individual/Organization/Institution)

Location/Address of Farm:
Purok Paghiusa, Brgy. Poblacion, Tampakan, South Cotabato

Total Farm Area: 1 has For Natural/Organic Farming Practice

Year started Farming: 2010
No. of Years in Farming: 13 years Area devoted to Organic Farming: ½ has.
Business Permit: ___________________________ Year started Organic Farming: 20126
No. of Years in Organic Farming: 8 yrs
No. of Workers:  Male _____2____       Female _________       Total ________________

C. FARM ENTERPRISE

Component
Area Devoted Ave. Annual Production Average Income
(commodities/projects)

D. FARM OPERATION 

ATI-QF/PAD-48 Rev. 04 Effectivity Date: August 2, 2022

List of Farm
Facilities

Other Facilities
____ Training/Activity Hall ____ Administrative Office
____ Toilet ____ Dormitory/Guest House
____ Wash Area (For farm tools and equipment) ____ Material Recovery Facility
____ Storage Room ____ Parking Area

Demonstration Area
____ Plant nursery
____ Fertilizer and Feeds production area
____ Vegetables, Herbs and Spices production area
____ Livestock production area
____ Poultry production area
____ Fishery production area
____ Cut Flowers, Ornamentals, and Succulents production area
____ Post-harvest area

Farm machinery/tools, specify below: Quantity

Prepared by:

RICHARD ROSS C. BARROSO

(Farm-Owner/Farm Manager/Farm-in-charge)

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our responsibilities and our data subject’s right under the Republic Act No. 10173, also known the Data
Privacy Act of 2012.
Privacy Consent
I have read and understand the Institute’s Data Privacy Statement and express my consent for ATI to
collect, store, use, share, process and update my personal information.

RICHARD ROSS C. BARROSO

Signature over printed name of Applicant

ATI-QF/PAD-48 Rev. 04 Effectivity Date: August 2, 2022