eval report cover.indd - New Jersey Farm to School Network Wiki

Survey of K-12 Food Service Providers in Michigan (Page 1 of 6)PLEASE NOTE: You are being asked to participate in a survey sent to all food servicedirector in Michigan contained in the Michigan Department of Education database.Th is survey is intended to aid the Department of Education in developing a Farm toSchool Program in Michigan. It is estimated that this will take 20 minutes of yourtime. Your participation in this survey is entirely voluntary, you may choose not toparticipate or you may refuse to or answer certain questions or discontinue yourparticipation at any time without penalty or loss of benefits. Return of this surveywill constitute informed consent. All information collected as part of this survey willremain confidential, it will be stored in a locked file in the offices of Dr. Hamm andthe surveys will be destroyed after 3 years. Access to the surveys will be restricted toinvestigators approved through the MSU Human Subjects Review procedure. Yourprivacy will be protected to the maximum extent allowable by law. There are noanticipated risks to you for participating. It is anticipated that you, as a food servicedirector, will benefit from helping determine the direction of a Farm to School Programin Michigan.If you have any question about this survey, please feel free to contact Mike Hamm,517-432-1611 or mhamm@msu.edu. If you have any questions or concerns regardingyour rights as a survey participant you may contact-anonymously, if you wish- PeterVasilenko, Ph.D., Chair of the University Committee on Research Involving HumanSubjects (UCRIHS) by phone: (517) 335-2180, fax: (517) 432-4503, email: ucrihs@msu.edu, or regular mail: 202 Olds Hall, East Lansing, MI 48824.Th ank you very much for you participation.Name:___________________School District or School:_____________________________1. Are you a member of any purchasing cooperatives?__ Yes __ NoFarm Conclusions to School and Sample RecommendationsTools and Resources2. If yes, are you a member of?__ SPARC__ Great Lakes Cooperative (GLC)__ Other: _____________________________________3. Who are your major vendors (please list the percentage or purchases you make fromthese vendors)1. ___________________________________ _________%2. ___________________________________ _________%3. ___________________________________ _________%4. ___________________________________ _________%5. ___________________________________ _________%www.farmtoschool.org 103