Gómez Garcia

1. DEMOGRAPHICS

Family

Name

Surname

Age

Experience

Availability to work on the project

2. HOUSING CONDITIONS

Number of Rooms in the House

Housing Comments

3. INTERVIEW

In the last month, have you experienced any of the following situations?

How many hours a day do you spend doing housework? (tasks that are considered in the space of the house)

How often do you eat the following foods?

Other (Which one?)

How would you like to improve the diet?

Other (Which one?)

If you checked other, please specify which:

What would you like to tell the project managers?

4. EFFORT TO CARRY OUT THE PROJECT

Total extension of the property in square meters

Total area of the property for the project in square meters

Number of trees for the project

Number of people available to work on the project

Estimated effort to carry out the project

Support required to carry out the project

Other crops

5. LOCATION

Property Name

Property Coordinates

Dirección del Predio

If the dwelling is not on the property, please indicate the location of the dwelling:

Dirección de la Vivienda

Housing coordinates

Additional Comments to the Interview

Interview Recording

00:00 / 54:06

Attach the recording of the interview

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living place

1/1

Attach 1 photograph of the home

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Attach 1 short video of the house

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property

1/1

Attach 1 photograph of the property

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Attach 1 short video of the property

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