JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Stellenbosch Food Security Initiative - Community Interventions Questionnaire
Please complete the following list of questions to be listed as an active food security project in the Stellenbosch and Winelands municipalities.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Referred by
From who did you hear about the survey? or Who recommended the respondent?
Your answer
Contact and organisation details
Project Name
*
Your answer
Do you provide any beneficiaries with food support?
*
If answer is 'No' - do you know a project that does?
Yes
No
Other:
Required
Contact Person Name
*
Your name
Your answer
Contact Number 1
*
Landline
Your answer
Contact Number 2
*
Mobile
Your answer
Contact email
Your answer
Contact Details: Street Adress
*
Most important detail is the neighborhood
Your answer
Services
How would you describe your project?
FOOD GARDEN development projects community
FOOD GARDEN development projects individual
FAITH BASED feeding schemes
OTHER FAITH BASED food projects
SOUP KITCHEN and other feeding schemes Non FBO
CORPORATE ad hoc feeding schemes facilitated in partnership with NGOs
NGO run feeding schemes where corporates are key donors but play no role in process and simply donate food
EMERGENCY response feeding schemes that fall outside state facilitated food aid
SCHOOL FEEDING SCHEME schemes to schools that cannot access formal DOE feeding scheme partners
OVC and HIV/Aids nutritional support schemes run by NGOs (support to other more direct interventions)
NGO food security work by organisations whose express brief is Food Security in Stellenbosch
Other:
When did your project start?
*
MONTH / YEAR
Your answer
Does your project do more than just provide food?
If yes, please describe the other activities you do.
No
Yes
Other:
How regularly do you provide food to your beneficiaries?
Daily
2- 3 times a week
Once a week
Monthly
Quarterly
When possible
Other:
Where do you distribute the food?
Quarterly
Monthly
Once a week
2 - 3 times a week
Daily
Project facility
House
Church
School
Government building
Parked vehicle
Delivery vehicle
Quarterly
Monthly
Once a week
2 - 3 times a week
Daily
Project facility
House
Church
School
Government building
Parked vehicle
Delivery vehicle
Clear selection
How many meals do you deliver in this time?
Guess the amount per the time period
Your answer
Constituents
How many adults receive the food in this period?
Guess the amount per the time period
Your answer
How many children aged under 7 receive the food in this period?
Guess the amount per the time period
Your answer
How many children aged 7 - 14 receive the food in this period?
Guess the amount per the time period
Your answer
How many children aged 14-18 receive the food in this period?
Guess the amount per the time period
Your answer
Out of ten, how many of your clients are female?
1
2
3
4
5
6
7
8
9
10
Clear selection
Description of food beneficiaries
Farm-workers
The homeless
People living with disabilities
Farm-worker children
Group members
Other:
Clear selection
If you are a member based scheme, how would you describe your group?
Church group
Cooperative
Neighborhood group
Club
Association
School Parents
Other:
Clear selection
Links to other organisations and projects
Who donates food to you?
Your answer
Where do you buy food for the project?
Your answer
Where do you grow food for the project?
Your answer
Which other projects depend on you?
Your answer
Next
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy
Help and feedback
Contact form owner
Help Forms improve
Report