Toward a Sustainable Agriculture, Module V Survey of consumer knowledge about organic foods Please circle the best response. 1. Are you familiar with the terms “organic food” and “organic agriculture”? 2. Have you ever been on an organic farm? Yes Yes No No 3. Can you list 3 or more activities prohibited in organic farming and food processing? Yes No Not sure If you answered “Yes” or “Not sure” please list some prohibited activities below. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 4. Can you list 3 or more things farmers or processors have to do to qualify as organic? Yes No Not sure If you answered “Yes” or “Not sure” please list some requirements below. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 5. Using the following numerical scale, please rate the overall impact of organic agriculture on each of the areas listed. 1 = very positive, 2 = somewhat positive, 3 = neutral, 4 = somewhat negative, 5 = very negative, 6 = don’t know Impact on the environment 1 2 3 4 5 6 Impact on human health 1 2 3 4 5 6 Impact on farm economics 1 2 3 4 5 6 Impact on people and communities 1 2 3 4 5 6 6. Can you explain what an organic certification agency is? Yes No If you answered “Yes” please give an example or explanation below. ________________________________________________________________________ ________________________________________________________________________ Toward a Sustainable Agriculture, Module V 7. Do you know where to buy organic food? Yes No 8. Do you have questions about organic agriculture, either as a result of this survey or in general? Yes No Please write the questions you would like this unit to answer ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 9. How often do you consume organic food? Several times a week More than once a month Occasionally Never 10. Please use the space below for any additional comments or questions. Don’t know