Remote Area Appliance Usage Survey
1. Basic Information
Name
Location/Village
Number of people in household
2. Available Power Source
What is your main source of electricity?
Grid
Solar
Generator
No electricity
Other
3. Appliance Ownership
Fan
Television
Refrigerator
Light
Radio
Mobile Charger
Other
4. Appliance Usage
How often do you use your appliances?
Daily
Weekly
Monthly
Average hours of electricity usage per day
5. Comments or Suggestions