Economic Survey

Topics: Cooperative, Economics Pages: 9 (828 words) Published: August 18, 2013
ECONOMIC SURVEY

OF

__________________________________________
(Name of Cooperative)

BACKGROUND:
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.

RATIONALE:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ .

GENERAL INFORMATION

A. Type of Cooperative:

_____ Credit _____ Producer _____ Multi-Purpose_____ Service _____ Consumer _____ Marketing _____ Advocay ______ARC _____ Coop Bank _____ Dairy ______Education ______ FSC _____ Electric _____ Fishermen ______Health Service _______ Water _____ Insurance _____ Transport ______Workers Other type (pls. specify):_________

B. Office Address of Cooperative: __________________________________________

____________________________________________________ District:__________ (No., Street, Brgy., Town / City, Province/District)

C. Area of Operation:_____ Barangay_____ Municipal_____ Provincial _____ City _____ Regional _____ National

D. Common Bond of Membership: _____ Residential _____ Institutional _____ Occupational _____ Associational

E. Composition of Members:
______ Farmers______ Indigenous Community _______ Youth ______ Fisherfolks______ Disabled_______ Women ______ ARB______ Rebel Returnees_______ OCW ______ Workers/Employees______ Others (Specify) ________________________

F. No. of Founding/Organizing Members: Total:_______________________( ) Male: ________ Female: ________

G. Projected Increase of Membership for:

First Year: ____________
Second Year: ____________
Third Year: ____________

1 Authorized Capital; P_______________________________________________

Subscribed Capital : P________________________________________________

Paid-up Capital : P __________________________________________________

Par Value P________________________________________________________

2 Is the proposed cooperative previously registered with:

SEC; ______ DOLE: ______ Others, specify: ____________ None: _________

1. STRATEGICAL OPERATIONAL STUDIES

3 Economic Aspect

1. Are there any other...
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