While you are not required to respond, your help is needed to provide data in developing plans for the proposed cooperative. Rural Business-Cooperative Service personnel will do all tabulations and analysis and answers are treated confidentially.

1. Name: ______________________________________________

Address: ______________________________________________

Town: _______________ State: ______ Zip Code: _______

Phone: (day) __________ (evening) __________ best time to call: ____

Farm Location: ______________________________________________

2. If a good operating plan can be developed, are you interested in joining the proposed cooperative? Yes _______ No ______

If yes: please go to Question 3.

If no: as a producer, do you wish to be kept informed about the proposed cooperative?

Yes ______ No ______ (Please go to question 19)

4.  How many acres do you currently have in production? ________________

5. Do you have storage facilities on your farm? Yes _____ No _____

6. Please check which services you would be interested in the cooperative providing:

Packing _______ Storage _______ Marketing ______ Distribution _____

Other______________________________________________________________

7. What is the maximum distance you would be willing to haul your product for processing?

Up to 5 miles ___ 6-10 miles ___ 11 to 25 miles ___

26-50 miles ___ 51-75 miles ___ 76 to 100 miles ___

8. Please complete the following table regarding your production.

9. What percent of your production do you usually market through each of the following?

On-farm _____% Wholesale Market _____% Roadside Stand _____%

Farmers Market _____% Grain Company _____% Other _____%

10. Assuming the cooperative was operational beginning January 1, 2002, how many acres of crops would you be willing to commit to the cooperative in the following years?

2002 _____ 2003 _____ 2004 _____

12. Would you be willing to follow the proposed cooperative's recommendations on what products to grow and cultural and harvesting practices? 
Yes _____ No _____

13. Would you be willing to adhere to quality standards for your crop established by the proposed cooperative? Yes _____ No _____

14. Cash funding by members would be needed for the proposed cooperative's start-up costs. Would you be willing to make an initial cash investment in the proposed cooperative in proportion to your intended use? Yes _____ No _____

16. Per-unit retains are a method of helping the cooperative meet its cash needs on a continuing basis. They would be withheld from patron's proceeds on a per-unit basis and credited to member's accounts. Are you willing to market your products in this manner? Yes _____ No _____

17. In a marketing pool, products are grouped by class and grade over a selected period of time. Producers are paid the average price the cooperative receives for the pooled products, less packing and marketing fees. Are you willing to market your products in this manner? Yes ___ No ___

_______________________________________________________________________________

______________________________________________________________________________.

19. Can your name and address be given to the steering committee so it can keep you informed about the proposed cooperative? Yes _____ No _____

20. Comments:

_______________________________________________________________________________

______________________________________________________________________________.

_______________________________________________________________________________

______________________________________________________________________________.

Thank you for completing this survey.

Please return this survey in the enclosed postage-paid envelope no later than , 2001.