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FARM TO SCHOOL CENSUS FAX–BACK QUESTIONNAIRE
If you would rather complete the Farm to School Census by hand and fax back, please use this form
and fax the form back to xxx‐xxx‐xxxx. If you need assistance, please call xxx‐xxx‐xxxx.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB
control number for this information collection is 0536-nnnn (expires [insert date]). The time required to complete
this information collection is estimated to average 9 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. This information collection is conducted under the authority of 7 U.S.C. 427.
Welcome to the Farm to School Census!
We know this year has been even busier than usual, and we deeply appreciate your time.
Your assistance in carrying out the Farm to School Census is vital for allocating grant funding and technical assistance for
Farm to School programs in your State that support local and regional economies and encourage healthy food choices.
Before you start, a few important reminders:
Please complete the questionnaire ‐‐ even if you don’t buy any locally produced food – we need your response to
estimate what percent of school districts ARE buying locally produced food.
The questionnaire has been kept as short as possible and should take about 20 minutes if you have a local
procurement program and only 5 minutes if you do not have one.
A few questions ask for the total value of food purchases from 2011‐12, and what percent of those purchases were
locally produced. Estimates are perfectly acceptable, so please don’t spend excessive amounts of time doing the
calculations. That said, if you already have that information, it will help to have it handy before you start.
The questionnaire does not include any personal or compliance‐related information. However, we must inform
you that your responses are not confidential and are not covered by the Confidential Information Protection and
Statistical Efficiency Act of 2002. USDA will treat all information gathered in accordance with the Freedom of
Information Act (5 U.S.C. 552).
Please also note that USDA has requested contact information for SFAs in each state in order to construct a list
frame to identify which SFAs have responded to the Farm to School Census and to contact a sample of non‐
respondents to request completion of an abridged set of questions. The list frame will be retained after the Farm
to School Census is completed for use in frame building and other statistical activities conducted by USDA or other
federal agencies.
Again, many thanks!
Deborah Kane
National Director, USDA Farm to School Program
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 1
1. School District Identification:
School District Name: (Please print complete district name without abbreviation)
5 digit ZIPCODE for the school district mailing address:
ID number assigned to your school district by your State Agency (if known):
2. Farm to School activities generally center around procurement of local or regional foods and
food, agriculture or nutrition‐based educational activities such as but not limited to:
Serving local food products in school (meals and snacks)
Serving local food products in classrooms (snacks, taste tests, educational tools)
Conducting educational activities related to local foods such as farmers in the classroom
and culinary education focused on local foods, field trips to farms, farmers' markets or food
processing facilities, and educational sessions for parents and community members
Creating and tending school gardens (growing edible fruits and vegetables)
Based on the definition above, did your district or any schools in your district participate in
Farm to School activities during the 2011/2012 school year? (Please check one.)
Yes
SKIP TO QUESTION 14 ON PAGE 8
No, but started activities in 2012/2013 school year PROCEED BELOW
SKIP TO QUESTION 8 ON PAGE 4
No, but plan to start activities in the future
No activities currently and no plans
SKIP TO QUESTION 11 ON PAGE 6
I don't know
SKIP TO QUESTION 13 ON PAGE 7
If the answer to Question 2 is “No, but started activities in 2012/13”,
please proceed to these questions:
3. Are you aware of the “geographic preference” option within USDA procurement rules that
allows districts to state a preference for local products in the specifications for bids on
minimally processed agricultural products and fish?
Yes
No
I don’t know
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 2
4. What activities are you starting this year? (Please check all that apply)
Serving locally produced foods in the cafeteria
Holding taste testing/demos of locally produced foods in the cafeteria, classroom or other
school‐related setting
Using cafeteria food coaches (e.g. adults or students in the cafeteria encouraging kids to eat
healthy/local foods)
Conducting edible school gardening or orchard activities
Serving products from school‐based gardens or school‐based farms in the cafeteria
Holding taste testing/demos of product from school‐based gardens or school‐based farms in
the cafeteria, classroom or other school‐related setting
Conducting student field trips to farms
Having farmer(s) visit the cafeteria, classroom or other school‐related setting
Promoting local efforts through themed or branded promotions (e.g. Harvest of the Month,
Local Day, Taste of Washington, etc.)
Promoting locally produced foods at school in general (e.g. via cafeteria signs, posters,
newsletters, etc.)
Generating media coverage local foods in schools (e.g. press interviews or other activities
that resulted in local coverage)
Hosting community events (e.g. invited parents to lunch, corn shucking contests, etc.)
Celebrating Farm to School Month (October 2011)
Integrating farm to school concepts into educational curriculum (math, science, language
arts, etc.)
Other: (please describe)
5. How does your district define "local" as it relates to your food procurement?
Same city/county
Produced within a 50 mile radius
Produced within a 100 mile radius
Produced within a 200 mile radius
Produced within a day’s drive
Produced within the State
Produced within the region
Geographic along with other restrictions
Other (please specify)
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 3
6. If you answered “produced within the region,” please describe your definition of region:
7. If you answered “Geographic along with other restrictions,” please specify other restrictions:
THANK YOU for completing this questionnaire! For more information on starting or expanding farm
to school activities, please see the National Farm to School Network at http://www.farmtoschool.org
or USDA’s Farm to School website at http://www.fns.usda.gov/cnd/F2S/.
Questions or comments?
Please contact: Deborah Kane,
National Director, USDA Farm to School Program
Deborah.Kane@fns.usda.gov
If the answer to Question 2 is “No, but planning to start activities in the
future”, please skip to these questions:
8. Are you aware of the “geographic preference” option within USDA procurement rules that
allows districts to state a preference for local products in the specifications for bids on
minimally processed agricultural products and fish?
Yes
No
I don’t know
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 4
9. What activities are you starting in the future? (Please check all that apply)
Serving locally produced foods in the cafeteria
Holding taste testing/demos of locally produced foods in the cafeteria, classroom or other school‐
related setting
Using cafeteria food coaches (e.g. adults or students in the cafeteria encouraging kids to eat
healthy/local foods)
Conducting edible school gardening or orchard activities
Serving products from school‐based gardens or school‐based farms in the cafeteria
Holding taste testing/demos of product from school‐based gardens or school‐based farms in the
cafeteria, classroom or other school‐related setting
Conducting student field trips to farms
Having farmer(s) visit the cafeteria, classroom or other school‐related setting
Promoting local efforts through themed or branded promotions (e.g. Harvest of the Month, Local
Day, Taste of Washington, etc.)
Promoting locally produced foods at school in general (e.g. via cafeteria signs, posters, newsletters,
etc.)
Generating media coverage local foods in schools (e.g. press interviews or other activities that
resulted in local coverage)
Hosting community events (e.g. invited parents to lunch, corn shucking contests, etc.)
Celebrating Farm to School Month (October 2011)
Integrating farm to school concepts into educational curriculum (math, science, language arts, etc.)
Other: (please describe)
10. When do you plan to start?
THANK YOU for completing this questionnaire! For more information on starting or expanding farm
to school activities, please see the National Farm to School Network at http://www.farmtoschool.org
or USDA’s Farm to School website at http://www.fns.usda.gov/cnd/F2S/.
Questions or comments?
Please contact: Deborah Kane, National Director,
USDA Farm to School Program
Deborah.Kane@fns.usda.gov
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 5
If the answer to Question 2 is “No activities currently, and no plans for the
future”, please skip to these questions:
11. Are you aware of the “geographic preference” option within USDA procurement rules that
allows districts to state a preference for local products in the specifications for bids on
minimally processed agricultural products and fish?
Yes
No
I don’t know
12. Are any of the following considered to be problems in procuring local products or reasons why
your district does not purchase local products? (Please check all that apply.)
Hard to find year‐round availability of key items
Local items not available from primary vendors
Vendors for local items don't offer a broad range of products
Higher prices
Unstable product prices
Lack of reliability in delivering ordered items
Lack of compliance with your institution’s purchasing regulations and policies
Lack of availability of processed/precut products
Lack of kitchen capacity/equipment to prepare fresh items
Hard to find new suppliers/growers or distributors
Hard to get information about product availability
Hard to place orders with vendors
Getting on‐time deliveries
Getting product delivered that meets your quality requirements and other specs, such as
size
Having quantity delivered equal to quantity ordered
Resolving problem deliveries
Inability to pay farmers according to farmers’ needs due to school district payment
procedures
Other, please describe:
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 6
THANK YOU for completing this questionnaire! For more information on starting or expanding farm to
school activities, please see the National Farm to School Network at http://www.farmtoschool.org or
USDA’s Farm to School website at http://www.fns.usda.gov/cnd/F2S/.
Questions or comments?
Please contact: Deborah Kane,
National Director, USDA Farm to School Program.
Deborah.Kane@fns.usda.gov
If the answer to Question 2 is “I don’t know”, please skip to this question:
13. Are you aware of the “geographic preference” option within USDA procurement rules that
allows districts to state a preference for local products in the specifications for bids on
minimally processed agricultural products and fish?
Yes
No
I don’t know
THANK YOU for completing this questionnaire! For more information on starting or expanding farm
to school activities, please see the National Farm to School Network at http://www.farmtoschool.org
or USDA’s Farm to School website at http://www.fns.usda.gov/cnd/F2S/.
Questions or comments?
Please contact: Deborah Kane
National Director, USDA Farm to School Program
Deborah.Kane@fns.usda.gov
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 7
If the answer to Question 2 is “Yes”, please skip to these questions:
14. To the best of your knowledge, please check the activities that any of your district’s schools
engaged in during 2011‐12 (Please check all that apply)
Served locally produced foods in the cafeteria
Held taste testing/demos of locally produced foods in the cafeteria, classroom or other school‐
related setting
Used cafeteria food coaches (e.g. adults or students in the cafeteria encouraging kids to eat
healthy/local foods)
Conducted edible school gardening or orchard activities
Served products from school‐based gardens or school‐based farms in the cafeteria
Held taste testing/demos of product from school‐based gardens or school‐based farms in the
cafeteria, classroom or other school‐related setting
Conducted student field trips to farms
Had farmer(s) visit the cafeteria, classroom or other school‐related setting
Promoted local efforts through themed or branded promotions (e.g. Harvest of the Month, Local
Day, Taste of Washington, etc.)
Promoted locally produced foods at school in general (e.g. via cafeteria signs, posters, newsletters,
etc.)
Generated media coverage local foods in schools (e.g. press interviews or other activities that
resulted in local coverage)
Hosted community events (e.g. invited parents to lunch, corn shucking contests, etc.)
Celebrated Farm to School Month (October 2011)
Integrated farm to school concepts into educational curriculum (math, science, language arts, etc.)
Other: (please describe)
15. During the 2011/12 school year, what age groups were targeted for Farm to School activities?
Please check all that apply.
Pre‐K
K through 5th grade
6th grade through 8th grade
9th grade through 12th grade
Other (please specify):
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 8
16. To the best of your knowledge, approximately how many schools participated in any Farm to
School activities during the 2011/12 school year?
17. To the best of your knowledge, approximately how many schools had edible school gardens
during the 2011/12 school year?
18. How does your district define "local" as it relates to your food procurement?
Same city/county
Produced within a 50 mile radius
Produced within a 100 mile radius
Produced within a 200 mile radius
Produced within a day’s drive
Produced within the State
Produced within the region
Geographic along with other restrictions
Other (please specify)
19. If you answered “produced within the region,” please describe your definition of region:
20. If you answered “Geographic along with other restrictions,” please specify other restrictions:
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 9
21. Are you aware of the “geographic preference” option within USDA procurement rules that
allows districts to state a preference for local products in the specifications for bids on
minimally processed agricultural products and fish?
Yes
No
I don’t know
22. During the 2011‐2012 school year, has your school district used the geographic preference
option in order to purchase minimally processed foods that have been locally grown, raised, or
produced?
Yes
No
I don’t know
23. Please indicate whether your district or any schools in your district used local products IN ANY
FORM (fresh, minimally processed, or processed) for any of the following Federal nutrition
programs during the 2011/2012 school year (check all that apply):
Breakfast
Lunch
Supper
Snacks
Fresh Fruit and Vegetable Program
Summer meals (i.e., meals in the Summer Food Service Program, in Seamless Summer, or
in the NLSP under accredited summer school programs)
24. For the 2011/12 school year, please indicate whether your district obtained local foods
DIRECTLY from the following sources (check all that apply):
Direct from individual food producers (i.e. farmers, fishers, ranchers)
Direct from farmer, rancher or fisher cooperatives
Direct from farmers markets
Via a Community Supported Agriculture (CSA) model
Direct from food processors and manufacturers
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 10
25. For the 2011/12 school year, please indicate whether your district obtained local foods from
any of the following INTERMEDIARY sources (check all that apply):
Distributors
Food buying cooperative
Food service management companies
DoD Fresh Program vendors
USDA Foods (formerly the USDA Commodity Program)
State Farm to School Program office
Other (please specify):
26. Please indicate if your district or any schools in your district purchased any of the following
foods – IN ANY FORM ‐‐ from local growers/producers/processers/manufacturers during the
2011‐12 school year or would like to in the future:
Yes
No
Fruit
I don’t
know
Vegetables
Fluid Milk
Other Dairy
Meat/poultry
Eggs
Seafood
Plant‐based protein items such as beans, seeds, nuts
Grains and flour
Bakery products
Herbs
Other (please specify)
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Not now, but would
like to in the future
Page 11
27. Please list the top 5 SPECIFIC food items (e.g. apples, chicken drumsticks) your school district
purchased locally in 2011/12, based on VALUE.
Food item #1:
Food item #2:
Food item #3:
Food item #4:
Food item #5:
28. On average, about how frequently do your district’s meals or snacks include at least one locally
sourced food item from the categories below?
Daily A few Weekly
A few
Monthly Occasionally Never
times per
times
per
month
week
Fruit
Vegetables
Fluid milk
Other Dairy
Meat/poultry
Eggs
Seafood
Plant‐based protein items
such as beans, seeds, nuts
Grains and flour
Bakery products
Herbs
Other (please specify):
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 12
The following questions ask about what you spent on food and local food in 2011/2012. Please give
your best approximation, and do not include USDA Foods or DOD Fresh.
29. For the 2011/2012 school year, what were your approximate total food costs?
$
,
,
.00
Total food cost (not counting USDA Foods/DOD Fresh): ____ ____ ____ ____ ____ ____ ____
30. For the 2011/2012 school year, about what percent of total food purchases were spent on
locally‐sourced foods including fluid milk?
1‐10%
11‐20%
21‐30%
31‐40%
41‐50%
50‐75%
76‐100%
I don't know
31. For the 2011/2012 school year, about what percent of total food purchases were spent on local
foods NOT INCLUDING FLUID MILK?
1‐10%
11‐20%
21‐30%
31‐40%
41‐50%
50‐75%
76‐100%
I don't know
32. Looking forward, do you anticipate your local purchases will:
Increase
Decrease
Stay the same
I don't know
Other (please specify):
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 13
33. Are any of the following considered to be problems in procuring local products or reasons why
your district does not purchase local products? (Please check all that apply.)
Local producers aren’t bidding
Hard to coordinate procurement of local with regular procurement
Hard to find year‐round availability of key items
Local items not available from primary vendors
Vendors for local items don't offer a broad range of products
Higher prices
Unstable product prices
Lack of reliability in delivering ordered items
Lack of compliance with your institution’s purchasing regulations and policies
Lack of availability of processed/precut products
Lack of kitchen capacity/equipment to prepare fresh items
Hard to find new suppliers/growers or distributors
Hard to get information about product availability
Hard to place orders with vendors
Getting on‐time deliveries
Getting product delivered that meets your quality requirements & other specs, i.e. size
Having quantity delivered equal to quantity ordered
Resolving problem deliveries
Inability to pay farmers according to farmers’ needs due to school district payment
procedures
Other, please describe:
34. Is there other information that was not asked for that you think we need to know?
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 14
35. (Optional) Please share a local food procurement success story.
THANK YOU for completing this questionnaire! For more information on starting or expanding farm to
school activities, please see the National Farm to School Network at http://www.farmtoschool.org or
USDA’s Farm to School website at http://www.fns.usda.gov/cnd/F2S/.
Questions or comments? Please contact: Deborah Kane, National Director, USDA Farm to School
Program. Deborah.Kane@fns.usda.gov
FARM TO SCHOOL CENSUS
FAX-BACK QUESTIONNAIRE
Page 15
| File Type | application/pdf |
| File Title | Microsoft Word - Revised Attachment O Farm to School Census Questionnaire Printable Version changes highlighted.docx |
| Author | KRALSTON |
| File Modified | 2013-02-14 |
| File Created | 2013-02-14 |