ANNEXURE - VIIa

RURAL POND FISH CULTURE EXTENSION ACTIVITIES REPORT
FAO Project TCP/BGD/4451 (T)

ANNEXURE-VIIb

STRENGTHENING RURAL POND FISH CULTURE EXTENSION SERVICES
TCP/BGD/4451(T)

SOCIO-ECONOMIC BASE LINE SURVEY

A. IDENTIFICATION INFORMATION

ID of RDFF             Date

Name of RDFF                                                                               Sex Male Female

Age                           Years         Father's Name                                                                               

Village                                                   Post Office                                                                            

Thana                                                   District                                                                                  

Education No Education Primary High School Graduate Above

B. SOCIO-ECONOMIC INFORMATION

1. OCCUPATIONAL INFORMATION (Please put tick mark at the appropriate box/boxes)

1.1	Major Occupation:
	Agriculture	Fish Farming	Daily Labour
	School Teacher	Govt. Service	Others
1.2	Minor Occupation:
	Agriculture	Fish Farming	Daily Labour
	School Teacher	Govt. Service	Others
1.3	Family Involvement in Fish Culture:
	Head of Family Adult Male member Adult Female member Children

2. FAMILY SIZE AND EDUCATION

2.1 Family member : (Please Mention Number in the box)

Male Female Children

2.2 Education Status of Family Member : (Please mention Number in the box)

School going College going Above None

3. FAMILY ASSETS :

3.1	Land Ownership : (Please mention the area in Decimal in the appropriate box)
	Crop Land Pond/Ditch Fallow
3.2	Land/pond on lease : (Please mention the area in Decimal in the appropriate box)
	Crop Land Pond/Ditch Fallow
3.3	Livestock ownership : (Please mention the Number and Value in Tk. in appropriate box (s)
	Bullock/Cow/Buffalo	Nos.		Tk.
	Calves/Sheep/Goat	Nos.		Tk.
	Chicken/Duck/Pigeon	Nos.		Tk.
3.4	House hold implements (Please mention the Number and Value in Tk. in appropriate box(s)
	Radio/Cassette	Nos.		Tk.
	Sewing machine	Nos.		Tk.
	Bi-Cycle	Nos.		Tk.
	Cart (bullock)	Nos.		Tk.
	Watch	Nos.		Tk.
	Chair	Nos.		Tk.
	Table	Nos.		Tk.
	Almirah	Nos.		Tk.
	Ulna	Nos.		Tk.
	Safe	Nos.		Tk.
	Hazal	Nos.		Tk.
	Kerosene Stove	Nos.		Tk.
	Motor Cycle	Nos.		Tk.
	Television	Nos.		Tk.
	Tubewell	Nos.		Tk.

4. LIVING STANDARD : (Please put tick at the appropriate box)

4.1	Type of House :
	Roof	Straw	Tin	Tile	Pucca
	Wall	Straw	Tin	Pucca	Bamboo fence	Mud
4.2	Sanitation facility :
	Kacha Pucca Open place
4.3	Health checking of family members :			Yes	No
	If yes, please tick the appropriate box(s) below :
	Private Clinic Govt. Hospital Quack Others
4.4	Using electricity in the house :			Yes	No
4.5	Source of drinking water:		Tube-well	Pond water	River water	Well
4.6	Family Food Consumption : (Please mention the data in the box)
	Fish consumption Kg/month			Kg.
	Vegetables consumption Kg/month			Kg.
	Oil consumption Kg/month			Kg.
	Fruits consumption kg/month			Kg.
	Others consumption kg/month			Kg.

5. FAMILY INCOME:

5.1	Yearly income flow:	Round the year	Part of year
5.2	Yearly income from fish culture		Tk.
5.3	Yearly total income		Tk.
5.4	Current bank loan taken for fish culture		Tk.
5.5	Current loan taken for other purpose		Tk.

6. FAMILY EXPENDITURE:

Yearly expenditure for Food	Tk.
Yearly expenditure for Clothes	Tk.
Yearly expenditure for Housing	Tk.
Yearly expenditure for Education	Tk.
Yearly expenditure for Health care	Tk.
Yearly expenditure for Sanitation	Tk.
Yearly bank loan Repayment	Tk.
Yearly others loan Repayment	Tk.

7. YEARLY PRODUCTION (Please mention in quantity in Kg and value in Tk.)

Spawn	Kg.	Tk.
Fry/Fingerling	Kg.	Tk.
Table fish	Kg.	Tk.
Rice	Kg.	Tk.
Vegetables	Kg.	Tk.
Others ( )	Kg.	Tk.

8. HOMESTEAD LAND/POND USE PATTERN : (Please put tick in the appropriate box)

Fish Farming	Yes	No
Vegetables cultivation	Yes	No
Gardening	Yes	No
Livestock farming	Yes	No
Others	Yes	No

9. FISH SALE :

9.1 Selling Location:

     Local Market Faroa Agent Wholesaler Pond site Others

9.2 Fish Price :

     Carp fish price Tk./kg Cat fish price Tk./kg    

     Shrimp price Tk./kg     Others (     ) Tk./kg      

10. TRAINING AND EXTENSION:

10.1 Training received: Yes No

      If yes, how many times Agency:

10.2 Interest in further improved method of fish culture: Yes No

10.3 Number of Fellow Fish Farmer (FFs)     Nos.

10.4 Number of converted RDFF                    Nos.

11. SOCIAL CONTACT & RELATIONSHIP:

11.1	Contact made with TFO/EO	Yes	No
11.2	Contact made with bank officers	Yes	No
11.3	Membership with cooperatives	Yes	No
11.4	Govt./Bank Officers visits his house	Yes	No
11.5	Any award/medal received so far	Yes	No
11.6	Get opportunity to address in meeting/groups	Yes	No
11.7	Invited to meet senior-level officers	Yes	No
11.8	People visit him for advice	Yes	No
11.9	Invited in social functions	Yes	No
11.10	Organized any social function within last one year	Yes	No

Data Collected by :                                                         Designation:                                    

ZIA/TILE

ANNEXURE VIIc

STRENGTHENING RURAL POND FISH CULTURE EXTENSION
SERVICES

FAO/TCP/BGD/4451

ACTIVITIES MONITORING SHEET

Give Tick mark ( ) at appropriate place.

STRENGTHENING RURAL POND FISH CULTURE EXTENSION
SERVICES

FAO/TCP/BGD/4451

ACTIVITIES MONITORING SHEET