LEARNING SITE FOR AGRICULTURE II (LSA II)

APPLICANT’S CHECKLIST OF REQUIREMENTS

Name of Farm - ________________________________________________________________________

Name of Farm Owner/ - ________________________________________________________________________

Institution

Land area (Hectare/s) - ________________________________________________________________________

Address - ________________________________________________________________________

Contact No. - ________________________________________________________________________

Email Address - ________________________________________________________________________

Category According to Technology Practiced:

_______ Farming LSA*: _______________________
_______ Agri-Processing Enterprise**: ______________________
*For Farming LSA: GAP, GAHP, Natural Farming, Organic Agriculture,
Integrated/Diversified Farming, Cut Flowers, Ornamentals and Succulents,
Halal, Urban Agriculture, Coconut-based
**For Agri-Processing Enterprise: Fruits and Vegetables, Meat, Fish, other
agricultural products

Not
Requirements Complied
Complied
Remarks

1. Letter of Intent

2. Endorsement by LGU/PLGU

3. Farm/Agri-Enterprise Profile Form

4. Certificate of Good Standing as LSA, with

recommendation for up-scaling to LSA II

5. Certificate of Training/Capability-Building

REMARKS:

______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Evaluated by:

____________________________________________
Signature over printed name
Designation:
Date:
ATI-QF/PAD-153 Rev. 00 Effectivity Date: August 2, 2022