Sample Survey For Consumers Template Page 3

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13. Do you have any suggestions that you would like to offer the committee planning the
new farmers market?
14. Would you like to participate in the planning committee for a new farmers market for
the community? If so please provide your contact information below.
Name:
________________________________________________________
Address:
________________________________________________________
________________________________________________________
Phone:
________________________________________________________
Email:
________________________________________________________
Professional Affiliation, if appropriate: _____________________________________
Thank you for your cooperation. The information you have provided will help us to
determine the level of support a new farmers market will have in the community. It will
also help us to develop a farmers market best suited to the community's interests.
Please complete this survey no later than _________ and drop in the Farmers Market
Drop Box placed in the following convenient locations:
Source:
“Guide to Developing a Community Farmers Market”, Farmers Market Federation of New York, NYS
Department of Agriculture & Markets, revised 2009.

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