Household Level Survey Form

Household Level Survey Form “The effects of economic change on land use in Mae Chaem District, Chiang Mai Province” Oral introduction: time frame, voluntary, information used for, confidentiality

Name of Village: ______ Interviewer: ______ Mu Thi: ______ Tambon ______ Date: ______

I. Interviewee Information Name(s): a)______b)______Address: ______

1.1 Relationship to household head: a) ____ b) ____ a)  b)  0. Household head, 1. Spouse of household head, 2. Child or child-in-law of HH, 3. Relative, 4. Other ______

1.2 Sex: a) ____ b) ____ 0. Male, 1. Female a)  b) 

1.3 Age(s): a) ____ b) ____ a)  b) 

1.4 Ethnicity: a) ____ b) ____ 0. Northern Thai, 1. Karen, 2. Hmong, 3. Other:______a)  b) 

1.5 Language Ability: a) good , fair , poor  b) good , fair , poor  a)  b) 

1.6 Personal History: a) 0. Since birth in this village , 1. Moved from within tambon , 2. Moved from within District , 3. Other Province  a)  b)  b) 0. Since birth in this village , 1. Moved from within tambon , 2. Moved from within District , 3. Other Province 

1.7 Length of Residence: a) 0. 0-2 years , 1. 3-5 years , 2. 6-10 years , 3. 11-20 years , 4. More than 20 years  a)  b)  b) 0. 0-2 years , 1. 3-5 years , 2. 6-10 years , 3. 11-20 years , 4. More than 20 years 

1.8 Reason for Moving: a) 0. Needed land , 1. Moved with parents , 2. Married into village , 3. Other  ______a)  b)  b) 0. Needed land , 1. Moved with parents , 2. Married into village , 3. Other  ______II. Household member information – Migration and Education

2.1 Family Size (number in household): ______people 

# Position Sex Age Education Main Other Work in Agriculture Ever worked outside 0. m, 1. f Never Currently Studying Completed Work Work Full time Seasonal/ Don’t work village? Studied (grade) (grade) Part time  = yes 1 Household head 2 3 4 5 6 7 8 9 10 Work Categories: 1. Agriculture, 2. Agriculture Wage Labor, 3. Other wage labor, 4. Trade, 5. Salaried/civil service, 6. Housework, 7. Nothing

2.2 Migrants ______people 

# First Departure Length of Stay Work done Reason for Reason for this Remittances Unemployed When (a) (Number of months or years) (b) Leaving (c) location (d) (Bht/yr) returned -  (year) Rainy Dry All year Not sure

a) Departure: 1. Past year, 2. 1-3 yrs ago, 3. 4-7 years ago, 4. 8-10 yrs ago, 5. More than 10 yrs ago b) Work: 1. Ag wage labor, 2. Factory/mill, 3. Service (rest, maid, driver etc), 4. Construction, 5. Govt wage work, 6. Sell things, 7. Other (write in)_____ c) 1 Reason: 1. Free from ag work, 2. Earn income for HH, 3. Take care of self, 4. Get experience, 5. Went with spouse, 6. Not sure, 7. Other (write) d) 2 Reason: 1. Relative lives there, 2. Friend/others went before, 3. Employer recruited, 4. Not sure, 5. Other (write) 2.3 Migration of Relatives How many relatives of your own generation have moved permanently from the village but still keep in touch? _____ 

# Relationship Sex Age 1 Age 2 Education 0. m (current) (when No Elementary High school HS + 1. f left) education (grade completed) (grade completed) 1 2 3 4 5 6 7 8

2.4 Children’s Education How many of your children are currently studying? ______

# School Type Location Attendance ( 1. Full time, 2. Part time) Expected highest Expected Cost El HS Univ Tech Annual Off season Peak season grade career Per year III. Agriculture and Land Use

III.1 Plot Characteristics

Plot # History Method Distance Area Land Intensity Title Tenure Crops (times planted, # crops) Water Source (a) (b) (km) (rai) Type (c) of Use (d) (e) Type (f) (*if enough water) (g) Rainy Dry Year 1: village area 2 3 4 5 6 a) History: year began using for agriculture b) Method Obtained: 1. Cleared from forest, 2. Taken over other fallow, 3. Borrowed from family/friends, 4. Rented, 5. Bought, 6. Other____ c) Land type: 1. Paddy, 2. Upland/mid slope, 3. Upland/steep, 4. Upland/Terraced 5. Other ______d) Intensity of use: 1. Planted to one crop only, 2. Rotating crops, 3. Shifting (write time frame), 4. Other ______e) Title type: 1. Full title, 2. NS 3, 3. STG, 4. SBG, 5. No title, 6. Other ______f) Tenure type: 1. Owns (years in use), 2. Rented (Bht/rai), 3. Sharecropped (%/rai), 4. Temporarily uses (years in use), 5. Other ______g) Water/Irrigation: 1. Rainfall, 2. Irrigation system, 3. Gravity fed pipes, 4. Pumped from river, 5. Other ______Or

Plot #: 1 2 3 4 5 6 7 Village area History: year began using for agriculture

Method Obtained: 1. Cleared from forest, 2. Taken over other fallow, 3. Borrowed from family/friends (who), 4. Rented, 5. Bought, 6. Other____

Distance from home: (km)

Area: (rai)

Land Type: 1. Paddy, 2. Upland/mid 3. Upland/steep, 4. Upland/Terraced 5. Other __

Intensity of Use: 1. Planted to one crop only, 2. Multiple crops (3), 3. Shifting (write time frame), 4. Other ______*partially planted last year

Title: 1. Full title, 2. NS 3, 3. STG, 4. SBG, 5. No title, 6. Other ______

Tenure type: 1. Owns (years in use), 2. Rented (Bht/rai), 3. Sharecropped (%/rai), 4. temporary/borrowed (years in use), 5. Other ______

Crops/rainy season: (times planted, # crops, *if enough rain) Crops/dry season: (times planted, # crops, *if enough rain) Crops/annually: (times planted, # crops, *if enough rain)

Plowing: 1. Large tractor (rent, own), 2. Small tractor (rent, own), 3. Animal (own, rent, borrow), 4. Hand, 5. Other ____

Water Source: 1. Rainfall, 2. Irrigation system, 3. Gravity fed pipes, 4. Pumped from river, 5. Other ______