Daonáireamh na hÉireann
Census of Population of Ireland
Sunday 23 April 2006
About the Census
Confidentiality is guaranteed
The Census takes place every five years and counts all the
people and households in the country. The census results will
give a comprehensive picture of the social and living conditions
of our people and will provide vital information necessary for
planning Ireland's future.
The confidentiality of your Census return is legally guaranteed
by the Statistics Act, 1993. The Central Statistics Office will
use the information you provide for statistical purposes only.
This includes the production of statistical tables and analytical
reports and the selection of samples for some of our surveys.
Participation is compulsory
Census Enumerator
The Census is being taken under the Statistics Act, 1993 and
the Statistics (Census of Population) Order, 2005. Under Section
26 of the Statistics Act, 1993, you are obliged by law to complete
this form. Any person who fails or refuses to provide this
information or who knowingly provides false information may be
subject to a fine of up to €25,000.
Your Census Enumerator will assist you if you have difficulty
completing your Census form or if you have any questions
about the Census.
Thank you for your co-operation.
Donal Garvey
Director General
Tá leagan Gaeilge den fhoirm seo le fáil ach í a iarraidh ón áiritheoir.
Who should complete the Census form?
The householder or any adult member of the household present
on the night of Sunday 23 April 2006 should complete the form.
Each household should complete a separate Household Form.
A household is:
How to complete your Census form
1. The form should be completed on the night of Sunday 23
April.
2. Please answer questions about your accommodation on page 2.
3. Identify on page 3:
all persons (including visitors) who spent the night of
Sunday 23 April in the household;
one person living alone or
a group of related/unrelated people living at the same
address with common housekeeping arrangements, that
is, sharing at least one meal a day or sharing a living room
or sitting room.
any household members who are usually resident in
the household but who are temporarily away on the
night of Sunday 23 April.
4. Answer the questions beginning on page 4 for all persons
present on the night of Sunday 23 April.
5. Answer the questions on pages 22-23 in respect of any
If you have any queries
household members temporarily away on the night of
Sunday 23 April.
Talk to your Census Enumerator if:
there is more than one household at your address (each
will need their own Household Form);
there are more than 6 persons in the household
(you will need an Individual Form for each additional person).
6. Sign the declaration on the back page.
Have your completed form ready for collection
The Enumerator will call to collect your completed Census
form on Monday 24 April or soon afterwards and will assist
you if you have any difficulties. If for any reason the form has
not been collected by Monday 22 May 2006, please return it
to our FREEPOST address which is Central Statistics Office,
PO Box 2006, FREEPOST 3985, Swords, Co Dublin.
For office use only
House Number and Street/Townland Name
County
Code
Page 1
Enumeration
Area Code
ED Code
Street/Townland Code
D No.
N u m b e r o f p e r so n s PR ESENT
Males
Females
Total
ABSENT
persons
HOUSEHOLD FORM
How to complete the Census Form
Please complete this form using a
BLACK or BLUE pen.
Tick boxes like this:
If you make a mistake:
Fill in the box like this:
1
Per week
correct one like this:
2
Per month
Please use BLACK or BLUE pen
H1
What type of accommodation
does your household occupy?
H3
A whole house or bungalow that is:
Detached
2
Semi-detached
3
Terraced (including end of terrace)
A flat or apartment (including
duplexes) that is self-contained:
4
In a purpose-built block
5
Part of a converted house or
commercial building
Owner occupied where loan or
mortgage repayments are being made
2
Owner occupied where no loan or
mortgage repayments are being made
3
Being purchased from a Local
Authority under a Tenant Purchase
Scheme
4
Rented from a Local Authority
5
Rented from a Voluntary Body
6
Rented unfurnished other than from
a Local Authority or Voluntary Body
7
Rented furnished or part furnished
other than from a Local Authority or
Voluntary Body
8
Occupied free of rent (caretaker,
company official, etc.)
H4
Bed-sit (with some shared facilities
e.g. toilet)
H2
A caravan or other mobile or
temporary structure
What year was your house or
other building containing your
accommodation first built?
Before 1919
2
1919 - 1940 inclusive
3
1941 - 1960 inclusive
4
1961 - 1970 inclusive
5
1971 - 1980 inclusive
6
1981 - 1990 inclusive
7
1991 - 1995 inclusive
8
1996 - 2000 inclusive
9
2001 or later
Page 2
N EW
Z E A L A N
D
H7
What type of piped water supply
does your accommodation have?
one box only.
1
Connection to a Public Main
2
Connection to a Group Water Scheme
with a Local Authority source of supply
Connection to a Group Water Scheme
with a private source of supply (e.g.
borehole, lake, etc.)
3
4
Connection to other private source
(e.g. well, lake, rain-water tank, etc.)
5
No piped water supply
H8
What type of sewerage facility
does your accommodation have?
one box only.
1
Public sewerage scheme
2
Individual septic tank
3
Individual treatment system other
than a septic tank
4
Other sewerage facility
5
No sewerage facility
H9
How many cars or vans are owned or
are available for use by one or more
members of your household?
Include any company car or van if
available for private use.
one box only.
to indicate
1
Per week
2
Per month
1
One
3
Per year
2
Two
3
Three
4
Four or more
Do NOT count bathrooms, toilets,
kitchenettes, utility rooms, consulting
rooms, offices, shops, halls or
landings, or rooms that can only be
used for storage such as cupboards.
5
None
Do count all other rooms for example
kitchens, living rooms, bedrooms,
conservatories you can sit in, and studies.
1
Yes
2
No
If two rooms have been converted
into one, count them as one room.
H11
H5
the year in which first built even if
the building was subsequently
converted, extended or renovated.
1
If your accommodation is rented,
how much rent does your
household pay?
Enter amount to the nearest Euro.
€
A mobile or temporary structure:
7
What is the nature of occupancy of
your household’s accommodation?
1
A bed-sit:
6
If elsewhere ABROAD, write in the
COUNTRY.
one box only.
one box only.
1
What is your place of birth?
Tick boxes like this
Questions about your accommodation
START HERE
EXAMPLE
Where you are required to write
in an answer please use
BLOCK CAPITAL LETTERS
and leave one space between
each word. Continue on to a new
line if a word will not fit, as in the
example.
How many rooms do you have for
use only by your household?
H10 Does your household have a
personal computer (PC)?
1
‘Yes’ if you have access to the
Internet in your home.
Yes, Broadband connection
2
Yes, other connection
3
No
Number of rooms
H6
Does your accommodation have
central heating?
1
‘Yes’ if you have central heating in some
or all rooms whether or not you use it.
Yes
2
No
Does your household have
access to the Internet?
H12
Proceed to next page
HOUSEHOLD FORM
Persons present in the household on the night of Sunday 23 April
List every person who spent the night of Sunday 23 April in the household or who arrived the following morning
not having been enumerated elsewhere.
INCLUDE
all persons alive at midnight on Sunday 23 April.
persons staying temporarily in the household.
DO NOT INCLUDE
students who are away from home on the night of Sunday 23 April; they should be listed as being absent in List 2 below.
babies born after midnight on Sunday 23 April.
anyone who is temporarily away from home on the night of Sunday 23 April. However, these persons should be
listed as being absent in List 2 below.
LIST 1
Person No.
Persons PRESENT in the household on the night of Sunday 23 April
First name and surname
1
2
3
4
5
6
Answer questions
relating to each
person present in the
household on Sunday
23 April beginning on
Page 4.
7
8
9
10
11
12
Answer questions
relating to persons
7, 8, 9 etc. on
additional Individual
Forms available
from your
Enumerator.
If there are more than 6 persons present in the household on the night of Sunday 23 April, you will need
an Individual Form for each additional person. Please ask your Enumerator.
Persons temporarily away from the household on the night of Sunday 23 April
List any household members who usually live at this address but who were ABSENT on the night of Sunday 23 April.
Include in particular students who are living away from home during term time who were not present on the night of
Sunday 23 April.
LIST 2
Person No.
1
2
3
4
5
6
Persons ABSENT from the household on the night of Sunday 23 April
First name and surname
You must answer
questions
beginning on Page
22 for each usual
resident listed here
as being absent
from the household
on the night of
Sunday 23 April.
If there are more than 6 usual residents absent on the night of Sunday 23 April, please ask your Enumerator
for guidance.
Please answer questions for each person present in the household on the night of
Sunday 23 April in the same order as listed in List 1 above beginning on Page 4.
Page 3
HOUSEHOLD FORM
1
2
Person 1
What is your name? (Person 1)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
11
Write in BLOCK CAPITALS
How many children have you
given birth to?
This question is for women only.
Write in number of children born alive.
Sex
1
Male
2
Female
3
7
1
Relationship question does not
apply to Person 1.
3
Elsewhere ABROAD, write in the
COUNTRY
12
None
Can you speak Irish?
Answer if aged 3 years or over.
1
Yes
2
No
IF ‘Yes’, do you speak Irish?
8
1
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
13
3
4
What is your date of birth?
Day
5
Month
Year
9
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
the COUNTRY of last previous residence.
If elsewhere ABROAD, write in the
COUNTRY.
10
1
2
3
one box only.
1
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 4
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
What is your religion?
4
5
C
6
2
Married (first Marriage)
7
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 1 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 5
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF ‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 1 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 6
34
Answer questions for Person 2 starting on the next page. If there is
only one person present in the household on the night of 23 April,
Skip to page 22
HOUSEHOLD FORM
1
2
Person 2
What is your name? (Person 2)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
Male
2
Female
What is your relationship to
Person 1?
See example on back page.
Relationship of
PERSON 2 to
Person
1
Husband or wife
1
Partner
2
Son or daughter
3
Step-child
4
Brother or sister
5
Mother or father
6
Step-mother/-father
7
Son-/daughter-in-law
8
Grandchild
9
Other related
10
Unrelated
(including foster child)
11
What is your date of birth?
Day
5
This question is for women only.
3
Elsewhere ABROAD, write in the
COUNTRY
Month
Year
12
8
1
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
3
9
2
No
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
What is your religion?
one box only.
1
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
10
3
Answer if aged 3 years or over.
Yes
13
If elsewhere ABROAD, write in the
COUNTRY.
2
Can you speak Irish?
IF ‘Yes’, do you speak Irish?
the COUNTRY of last previous residence.
1
None
1
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 7
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
Write in BLOCK CAPITALS
How many children have you
given birth to?
Write in number of children born alive.
1
one box only.
4
11
Sex
1
3
7
4
5
C
6
2
Married (first Marriage)
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
7
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 2 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 8
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF ‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 2 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 9
34
Answer questions for Person 3 starting on the next page. If there are
only two persons present in the household on the night of 23 April,
Skip to page 22
HOUSEHOLD FORM
1
2
Person 3
What is your name? (Person 3)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
Male
2
Female
What is your relationship to
Persons 1 and 2?
See example on back page.
Relationship of
PERSON 3 to
Persons
1 2
Husband or wife
1
Partner
2
Son or daughter
3
Step-child
4
Brother or sister
5
Mother or father
6
Step-mother/-father
7
Son-/daughter-in-law
8
Grandchild
9
Other related
10
Unrelated
(including foster child)
11
3
This question is for women only.
Elsewhere ABROAD, write in the
COUNTRY
Month
12
8
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
3
9
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
2
No
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
If elsewhere ABROAD, write in the
COUNTRY.
10
2
3
What is your religion?
one box only.
1
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
the COUNTRY of last previous residence.
1
Answer if aged 3 years or over.
Yes
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 10
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
Can you speak Irish?
1
13
Year
None
IF ‘Yes’, do you speak Irish?
1
What is your date of birth?
Day
5
Write in BLOCK CAPITALS
How many children have you
given birth to?
Write in number of children born alive.
1
one box only for each person.
4
11
Sex
1
3
7
4
5
C
6
2
Married (first Marriage)
7
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 3 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 11
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF ‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 3 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 12
34
Answer questions for Person 4 starting on the next page. If there are
only three persons present in the household on the night of 23 April,
Skip to page 22
HOUSEHOLD FORM
1
2
Person 4
What is your name? (Person 4)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
Male
2
Female
What is your relationship to
Persons 1, 2 and 3?
See example on back page.
Relationship of
PERSON 4 to
Persons
1 2 3
Husband or wife
1
Partner
2
Son or daughter
3
Step-child
4
Brother or sister
5
Mother or father
6
Step-mother/-father
7
Son-/daughter-in-law
8
Grandchild
9
Other related
10
Unrelated
(including foster child)
11
3
This question is for women only.
Elsewhere ABROAD, write in the
COUNTRY
Month
12
8
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
3
9
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
2
No
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
If elsewhere ABROAD, write in the
COUNTRY.
10
2
3
What is your religion?
one box only.
1
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
the COUNTRY of last previous residence.
1
Answer if aged 3 years or over.
Yes
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 13
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
Can you speak Irish?
1
13
Year
None
IF ‘Yes’, do you speak Irish?
1
What is your date of birth?
Day
5
Write in BLOCK CAPITALS
How many children have you
given birth to?
Write in number of children born alive.
1
one box only for each person.
4
11
Sex
1
3
7
4
5
C
6
2
Married (first Marriage)
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
7
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 4 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 14
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF ‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 4 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 15
34
Answer questions for Person 5 starting on the next page. If there are
only four persons present in the household on the night of 23 April,
Skip to page 22
HOUSEHOLD FORM
1
2
Person 5
What is your name? (Person 5)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
Male
2
Female
What is your relationship to
Persons 1, 2, 3 and 4?
See example on back page.
Relationship of
PERSON 5 to
Persons
1 2 3 4
Husband or wife
1
Partner
2
Son or daughter
3
Step-child
4
Brother or sister
5
Mother or father
6
Step-mother/-father
7
Son-/daughter-in-law
8
Grandchild
9
Other related
10
Unrelated
(including foster child)
11
3
This question is for women only.
Elsewhere ABROAD, write in the
COUNTRY
Month
12
8
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
3
9
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
2
No
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
If elsewhere ABROAD, write in the
COUNTRY.
10
2
3
What is your religion?
one box only.
1
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
the COUNTRY of last previous residence.
1
Answer if aged 3 years or over.
Yes
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 16
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
Can you speak Irish?
1
13
Year
None
IF ‘Yes’, do you speak Irish?
1
What is your date of birth?
Day
5
Write in BLOCK CAPITALS
How many children have you
given birth to?
Write in number of children born alive.
1
one box only for each person.
4
11
Sex
1
3
7
4
5
C
6
2
Married (first Marriage)
7
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 5 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 17
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 5 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 18
34
Answer questions for Person 6 starting on the next page. If there are
only five persons present in the household on the night of 23 April,
Skip to page 22
HOUSEHOLD FORM
1
2
Person 6
What is your name? (Person 6)
First name and surname
Tick boxes like this
Where do you usually live?
1
HERE at this address
2
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
Male
2
Female
What is your relationship to
Persons 1, 2, 3 and 4?
See example on back page.
Relationship of
PERSON 6 to
Persons
1 2 3 4
Husband or wife
1
Partner
2
Son or daughter
3
Step-child
4
Brother or sister
5
Mother or father
6
Step-mother/-father
7
Son-/daughter-in-law
8
Grandchild
9
Other related
10
Unrelated
(including foster child)
11
3
This question is for women only.
Elsewhere ABROAD, write in the
COUNTRY
Month
12
8
2
Where did you usually live one
year ago?
Answer if aged 1 year or over.
SAME as now
Elsewhere in IRELAND (including
Northern Ireland), write in the COUNTY
3
9
Elsewhere ABROAD, write in the
COUNTRY
Have you lived outside the
Republic of Ireland for a
continuous period of one year or
more?
2
No
the boxes that apply.
1
Daily, within the education system
2
Daily, outside the education system
3
Weekly
4
Less often
5
Never
What is your place of birth?
Give the place where your mother lived
at the time of your birth.
If IRELAND (including Northern Ireland),
write in the COUNTY.
1
Yes
2
No
IF ‘Yes’, write in
the YEAR of last taking up residence in
the Republic of Ireland
If elsewhere ABROAD, write in the
COUNTRY.
10
2
3
What is your religion?
one box only.
1
Roman Catholic
2
Church of Ireland
3
Presbyterian
4
Methodist
5
Islam
6
Other, write in your RELIGION
7
No religion
Answer if aged 1 year or over and
living in Ireland.
the COUNTRY of last previous residence.
1
Answer if aged 3 years or over.
Yes
14
What is your Nationality?
If you have more than one nationality,
please declare all of them.
Irish
Other NATIONALITY, write in
No nationality
Page 19
1
A
1
Answer if aged 15 years or over.
one box only.
Single (never Married)
White
Irish
2
Irish Traveller
3
Any other White background
B
What is your current marital
status?
What is your ethnic or cultural
background?
Choose ONE section from A to D,
then
the appropriate box.
AND
6
Can you speak Irish?
1
13
Year
None
IF ‘Yes’, do you speak Irish?
1
What is your date of birth?
Day
5
Write in BLOCK CAPITALS
How many children have you
given birth to?
Write in number of children born alive.
1
one box only for each person.
4
11
Sex
1
3
7
4
5
C
6
2
Married (first Marriage)
3
Re-married (following Widowhood)
D
4
Re-married (following Divorce/Annulment)
8
5
Separated (including Deserted)
6
Divorced
7
Widowed
7
Black or Black Irish
African
Any other Black background
Asian or Asian Irish
Chinese
Any other Asian background
Other, including mixed background
Other, write in description
HOUSEHOLD FORM
Person 6 - continued
15
Do you have any of the following
long-lasting conditions?
(a) Blindness, deafness or a Yes No
severe vision or hearing
1
2
impairment
(b) A condition that
substantially limits one or
more basic physical
activities such as walking, Yes No
climbing stairs, reaching,
1
2
lifting or carrying
(c) A learning or intellectual
disability
(d) A psychological or
emotional condition
(e) Other, including any
chronic illness
16
Yes No
1
2
Yes No
1
(d) Working at a job or
business or attending
school or college
Yes No
1
2
1
06:31 - 07:00
1
No formal education
3
07:01 - 07:30
2
Primary education
4
07:31 - 08:00
3
Second Level
Lower secondary:
4
Upper secondary:
5
Technical or Vocational qualification:
6
Both Upper Secondary and Technical or
Vocational qualification
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
After 09:30
9
Not applicable
19
What distance is your
journey from home to work,
school or college and how
long does it usually take?
2
Primary Degree (Third Level Bachelor Degree)
9
Professional qualification (of Degree status
at least)
10
Both a Degree and a Professional qualification
11
Postgraduate Certificate or Diploma
12
Postgraduate Degree (Masters)
If you are aged under 15,
13
Doctorate (Ph.D)
Skip to Q34 on next page
24
Yes No
1
2
21
one box only, for the longest
part, by distance, of your usual
journey to work, school or
college.
On foot
Do you provide regular
unpaid personal help for a
friend or family member with
a long-term illness, health
problem or disability?
Include problems which are due
to old age.
Personal help includes help with
basic tasks such as feeding or
dressing.
1
Yes, 1-14 hours a week
2
Yes, 15-28 hours a week
3
Yes, 29-42 hours a week
2
Bicycle
4
Yes, 43 or more hours a week
3
Bus, minibus or coach
5
No
4
Train, DART or LUAS
5
Motor cycle or scooter
6
Driving a car
7
Passenger in a car
1
Yes
8
Lorry or van
2
No
9
Other means
10
Work mainly at or from home
11
Not applicable
22
Completed Apprenticeship, NCVA Level 2/3 Certificate,
Teagasc Certificate/Diploma or equivalent
8
Minutes
Yes No
Leaving Certificate (including Applied and Vocational
Programmes),‘A’ Levels, NCVA Level 1 Certificate or
equivalent
Third Level
Non Degree:
Kilometres
20
Junior/Intermediate/Group Certificate, ‘O’ Levels/GCSEs,
NCVA Foundation Certificate, Basic Skills Training
Certificate or equivalent
7
Write in distance to the nearest
kilometre and journey time in
minutes.
How do you usually travel
to work, school or college?
Page 20
one box only.
2
2
1
Write in BLOCK CAPITALS
What is the highest level of education
(full-time or part-time) which you have
completed to date?
Before 06:30
Yes No
(e) Participating in other
Yes No
activities, for example
1
2
leisure or using transport
1
23
2
(b) Dressing, bathing or
Yes No
getting around inside the
1
2
home
(c) Going outside the home
alone to shop or visit a
doctor’s surgery
Tick boxes like this
What time do you usually
leave home to go to work,
school or college?
1
IF ‘Yes’, to any of the conditions
specified in Question 15, do you
have any difficulty in doing any of
the following activities?
(a) Learning, remembering
or concentrating
17
18
Have you ceased your
full-time education?
IF ‘Yes’, write in AGE at
which it ceased.
National Certificate, Diploma NCEA/Institute of Technology
or equivalent, Nursing Diploma
Do you hold any THIRD LEVEL
qualification(s) which you attained after
completing 2 or more years of study?
1
Yes
2
No
IF ‘Yes’, please indicate the main subject
area(s) in which the qualification(s) is held.
ALL the boxes that apply.
1
Education
2
Humanities and Arts (including Foreign Languages,
3
Social Sciences/Business/Law (including
4
Life Science, Physical Science, Mathematics
and Statistics
5
Computing
6
Engineering, Manufacturing and Construction
7
Agriculture and Veterinary (including Forestry,
8
Health (including Medicine, Nursing, Dental Studies,
9
Social Services (including Child Care and Youth
10
Services (including Hotel, Catering, Sports, Transport,
History, Philosophy, Fine Arts, Music and Performing Arts,
Design)
Psychology, Economics, Journalism, Finance, Accounting)
(including Architecture)
Fishery, Horticulture)
Therapy and Rehabilitation, Pharmacy)
Services, Social Work and Counselling)
Environmental Protection, Security, Occupational Health
and Safety, Military and Defence)
HOUSEHOLD FORM
Person 6 - continued
25
In the last 4 weeks have you done any
of the following activities without pay?
29
ALL the boxes that apply.
1
Helping or voluntary work with a social or
charitable organisation
2
Helping or voluntary work with a religious
group or church
3
Helping or voluntary work with a sporting
organisation
4
Helping or voluntary work with a political or
cultural organisation
5
Any other voluntary activity
6
No voluntary activity
26
2
Looking for first regular job
3
Unemployed
4
Student or pupil
5
Looking after home/family
6
Retired from employment
7
Unable to work due to permanent
sickness or disability
8
Other, write in
If you are:
working for payment or
profit (Q26 box 1),
unemployed (Q26 box 3),
retired (Q26 box 6),
answer the following questions about
your main job or your last main job if you
are not currently employed.
30
If you are retired,
31
What is (was) the full name of the Organisation you work(ed) for in
your main job?
Skip to Q34
If you have (had) your own business, write in the NAME of the business.
1
33
What is (was) the full address at which you actually work(ed)?
Work mainly at or from home
2
No fixed place of work
What is (was) the business of your employer at the place where
you work(ed) in your main job?
If you are (were) self-employed answer in respect of your own business.
Describe the main product or service provided by your employer.
For example, MAKING COMPUTERS, REPAIRING CARS, SECONDARY
EDUCATION, FOOD WHOLESALE, MAKING PHARMACEUTICALS,
CONTRACT CLEANING, SOFTWARE DEVELOPMENT AND SUPPORT.
Otherwise,
Skip to Q34
28
In all cases describe the occupation fully and precisely giving the full job title.
Use precise terms such as
Do NOT use general terms such as
RETAIL STORE MANAGER
Manager
SECONDARY TEACHER
Teacher
ELECTRICAL ENGINEER
Engineer
Civil servants and local government employees should state their grade e.g.
SENIOR ADMINISTRATIVE OFFICER. Members of the Gardaí or Army should
state their rank. Teachers should state the branch of teaching e.g. PRIMARY
TEACHER. Clergy and religious orders should give full description e.g. NUN,
REGISTERED GENERAL NURSE.
Hectares
32
27
What is (was) your occupation in your main job?
If a farmer or farm worker, write in the SIZE of the farm.
one box only.
Working for payment or profit
Write in BLOCK CAPITALS
Write in your main OCCUPATION.
How would you describe your
present principal status?
1
Tick boxes like this
Do (did) you work as an employee or
are (were) you self-employed in your
main job?
Your main job is the job in which you usually
work(ed) the most hours.
1
Employee
2
Self-employed, with paid employees
3
Self-employed, without paid employees
4
Assisting relative (not receiving a fixed wage
or salary)
Page 21
34
If there are more than 6 persons present in the household on the night
of Sunday 23 April, you will need an Individual Form for each additional
person. Please ask your Enumerator for additional forms.
Otherwise,
Go to the next page
HOUSEHOLD FORM
Persons temporarily away from the household on the night of Sunday 23 April
Answer questions A1 to A8 for any household members who usually live here at this address but who are NOT present
on the night of Sunday 23 April. Include in particular students who are living away from home during term time who
are NOT present at this address on the night of Sunday 23 April.
A1
A2
Absent Person 1
What is this person’s name?
First name and surname
A1
A2
Sex
Absent Person 2
What is this person’s name?
First name and surname
A1
A2
Sex
Absent Person 3
What is this person’s name?
First name and surname
Sex
1
Male
1
Male
1
Male
2
Female
2
Female
2
Female
A3
What is the relationship of this
person to Person 1 on page 4?
A3
one box only.
What is the relationship of this
person to Person 1 on page 4?
A3
one box only.
What is the relationship of this
person to Person 1 on page 4?
one box only.
1
Husband or wife
1
Husband or wife
1
Husband or wife
2
Partner
2
Partner
2
Partner
3
Son or daughter
3
Son or daughter
3
Son or daughter
10
Other related, write in RELATIONSHIP
10
Other related, write in RELATIONSHIP
10
Other related, write in RELATIONSHIP
11
Unrelated (including foster child)
11
Unrelated (including foster child)
11
Unrelated (including foster child)
A4
What is this person’s date of birth?
Day
A5
Month
A4
Year
What is this person’s current
marital status?
What is this person’s date of birth?
Day
A5
Answer if aged 15 years or over.
one box only.
Month
A4
Year
What is this person’s current
marital status?
What is this person’s date of birth?
Day
A5
Answer if aged 15 years or over.
one box only.
Month
Year
What is this person’s current
marital status?
Answer if aged 15 years or over.
one box only.
1
Single (never Married)
1
Single (never Married)
1
Single (never Married)
2
Married (including Re-married)
2
Married (including Re-married)
2
Married (including Re-married)
5
Separated (including Deserted)
5
Separated (including Deserted)
5
Separated (including Deserted)
6
Divorced
6
Divorced
6
Divorced
7
Widowed
7
Widowed
7
Widowed
A6
How long altogether is this person
away for?
A6
How long altogether is this person
away for?
A6
How long altogether is this person
away for?
1
Less than 3 months
1
Less than 3 months
1
Less than 3 months
2
3 months or more
2
3 months or more
2
3 months or more
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
1
Yes
1
Yes
1
Yes
2
No
2
No
2
No
A8
Is this person a student away at
school or college?
A8
Is this person a student away at
school or college?
A8
Is this person a student away at
school or college?
1
Yes
1
Yes
1
Yes
2
No
2
No
2
No
Page 22
HOUSEHOLD FORM
Persons temporarily away from the household on the night of Sunday 23 April
A1
A2
Absent Person 4
What is this person’s name?
First name and surname
A1
A2
Sex
Absent Person 5
What is this person’s name?
First name and surname
A1
A2
Sex
Absent Person 6
What is this person’s name?
First name and surname
Sex
1
Male
1
Male
1
Male
2
Female
2
Female
2
Female
A3
What is the relationship of this
person to Person 1 on page 4?
A3
one box only.
What is the relationship of this
person to Person 1 on page 4?
A3
one box only.
What is the relationship of this
person to Person 1 on page 4?
one box only.
1
Husband or wife
1
Husband or wife
1
Husband or wife
2
Partner
2
Partner
2
Partner
3
Son or daughter
3
Son or daughter
3
Son or daughter
10
Other related, write in RELATIONSHIP
10
Other related, write in RELATIONSHIP
10
Other related, write in RELATIONSHIP
11
Unrelated (including foster child)
11
Unrelated (including foster child)
11
Unrelated (including foster child)
A4
What is this person’s date of birth?
Day
A5
Month
A4
Year
What is this person’s current
marital status?
What is this person’s date of birth?
Day
A5
Answer if aged 15 years or over.
one box only.
Month
A4
Year
What is this person’s current
marital status?
What is this person’s date of birth?
Day
A5
Answer if aged 15 years or over.
one box only.
Month
Year
What is this person’s current
marital status?
Answer if aged 15 years or over.
one box only.
1
Single (never Married)
1
Single (never Married)
1
Single (never Married)
2
Married (including Re-married)
2
Married (including Re-married)
2
Married (including Re-married)
5
Separated (including Deserted)
5
Separated (including Deserted)
5
Separated (including Deserted)
6
Divorced
6
Divorced
6
Divorced
7
Widowed
7
Widowed
7
Widowed
A6
How long altogether is this person
away for?
A6
How long altogether is this person
away for?
A6
How long altogether is this person
away for?
1
Less than 3 months
1
Less than 3 months
1
Less than 3 months
2
3 months or more
2
3 months or more
2
3 months or more
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
A7
Was this person in the Republic
of Ireland on Sunday 23 April?
1
Yes
1
Yes
1
Yes
2
No
2
No
2
No
A8
Is this person a student away at
school or college?
A8
Is this person a student away at
school or college?
A8
Is this person a student away at
school or college?
1
Yes
1
Yes
1
Yes
2
No
2
No
2
No
If there are more than 6 persons temporarily absent from
the household on the night of Sunday 23 April, please ask
your Enumerator for guidance.
Page 23
Please sign the declaration on the back page.
HOUSEHOLD FORM
Declaration to be signed by the householder after completing the Census form
Before you sign the declaration please check:
That you have completed the questions about your accommodation on page 2.
That in List 1 on page 3, you have accounted for all persons (including visitors) who spent the night of Sunday 23 April in
the household (if there are more than 6 persons present, please complete the relevant number of Individual Forms).
That you have answered all questions which should have been answered for each person who spent the night of Sunday
23 April in the household (pages 4-21).
That in List 2 on page 3, you have accounted for all household members who were temporarily away from the household
on the night of Sunday 23 April (if there are more than 6 absent persons, please ask your Enumerator for guidance).
That you have answered all questions on pages 22-23 for all household members temporarily away from the household
on the night of Sunday 23 April.
That no person has been double counted on the form.
Declaration to be completed by the person responsible for completing the form
I declare that this form is correct and complete to the best of my knowledge and belief.
Signature
You have now completed the Census form.
Thank you for your co-operation.
Example - Question 3 - Household members and their Relationships within the Household
For a household consisting of up to 5 persons, all persons after Person 1 in the household, are required to give
their relationship to the persons previously listed. For households consisting of 6 or more persons, Persons 5
and higher are required to give their relationship to Persons 1-4 only.
The example below shows how to complete the relationship question for a household consisting of: Helen Murphy,
her husband Thomas, their daughter Catherine and grandchild Aoife (Catherine's daughter).
Relationship question does
not apply to Person 1
HELEN MURPHY
Name of Person 2
Name of Person 3
THOMAS MURPHY
one box only.
Relationship of
PERSON 2 to
Husband or wife
CATHERINE MURPHY
one box only for each person.
Person
1
Relationship of
PERSON 3 to
Persons
1 2
AOIFE MURPHY
one box only for each person.
Persons
1 2 3
Relationship of
PERSON 4 to
1
Husband or wife
1
Husband or wife
1
Partner
2
Partner
2
Partner
2
Son or daughter
3
Son or daughter
3
Son or daughter
3
Step-child
4
Step-child
4
Step-child
4
Brother or sister
5
Brother or sister
5
Brother or sister
5
Mother or father
6
Mother or father
6
Mother or father
6
Step-mother/-father
7
Step-mother/-father
7
Step-mother/-father
7
Son-/daughter-in-law
8
Son-/daughter-in-law
8
Son-/daughter-in-law 8
Grandchild
9
Grandchild
9
Grandchild
9
Other related
10
Other related
10
Other related
10
Unrelated
11
Unrelated
11
Unrelated
11
(including foster child)
Page 24
Name of Person 4
(including foster child)
(including foster child)
HOUSEHOLD FORM
Project1
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Page 2
Daonáireamh na hÉireann
Census of Population of Ireland
Dé Domhnaigh 23 Aibreán 2006
Faoin Daonáireamh
Ráthaítear rúndacht
Bíonn an Daonáireamh ann gach cúig bliana agus áiríonn sé
na daoine agus na teaghlaigh ar fad sa tír. Tabharfaidh torthaí
an Daonáirimh léargas cuimsitheach ar dhálaí sóisialta agus
maireachtála ár bpobail chomh maith le eolas tábhachtach
riachtanach le todhchaí na hÉireann a phleanáil.
Tá rúndacht do thuairisceáin Daonáirimh ráthaithe ó thaobh dlí
ag an Acht Staidrimh, 1993. Bainfidh an Phríomh-Oifig Staidrimh
úsáid as an eolas a sholáthraíonn tú ar chúiseanna staidrimh
amháin. San áireamh tá soláthar táblaí staidrimh agus tuairiscí
anailíse agus roghnú samplaí do chuid d'ár suirbhéanna.
Tá an rannpháirteachas éigeantach
Áiritheoir Daonáirimh
Tá an Daonáireamh á dhéanamh faoin Acht Staidrimh, 1993
agus faoin Ordú Staidrimh (Daonáireamh), 2005. Faoi Alt 26
den Acht Staidrimh, 1993, ní mór duit de réir dlí an fhoirm seo
a chomhlánú. Féadfar fíneáil suas le €25,000 a ghearradh ar
aon duine a dteipeann air/uirthi, nó a dhiúltaíonn, an t-eolas
seo a sholáthar nó a sholáthraíonn eolas bréagach go feasach.
Cabhróidh d'Áiritheoir leat má tá deacracht agat an fhoirm
Dhaonáirimh a chomhlánú nó má tá aon cheisteanna agat
faoin Daonáireamh.
Go raibh maith agat as do chomhoibriú.
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
Dónal Ó Gairbhí
An tArd-Stiúrthóir
!
N
This form is also available in English. Please ask your Enumerator.
Cé a chomhlánóidh an fhoirm Dhaonáirimh
Conas an Fhoirm Dhaonáirimh a chomhlánú
Ba chóir go ndéanfadh an ceann teaghlaigh nó aon bhall
aosach den teaghlach atá i láthair oíche Dé Domhnaigh,
23 Aibreán 2006, an fhoirm a chomhlánú.
1. Ba chóir an fhoirm a chomhlánú oíche Dé Domhnaigh,
Ba chóir do gach teaghlach Foirm Theaghlaigh ar leith a
chomhlánú.
Is éard atá i dteaghlach ná:
duine amháin atá ina c(h)ónaí leis/léi féin, nó
grúpa daoine gaolta/neamhghaolta atá ina gcónaí ag an
seoladh céanna le comhshocruithe tís, is é sin, ag comhroinnt
béile amháin ar a laghad sa lá nó ag comhroinnt seomra
teaghlaigh nó seomra suí.
Má tá aon cheisteanna agat
Labhair leis an Áiritheoir Daonáirimh má:
tá níos mó ná teaghlach amháin ag do sheoladh (teastóidh
Foirm Theaghlaigh ar leith ó gach teaghlach);
tá níos mó ná seisear sa teaghlach (teastóidh Foirm
Phearsan Aonair do gach duine breise).
23 Aibreán.
2. Freagair na ceisteanna faoi do chóiríocht ar leathanach 2,
le do thoil.
3. Aithin ar leathanach 3:
gach duine (lena n-áirítear cuairteoirí) a chaith oíche
Dé Domhnaigh, 23 Aibreán, sa teaghlach;
aon bhaill den teaghlach a mbíonn cónaí orthu de
ghnáth sa teaghlach ach atá as baile go sealadach
oíche Dé Domhnaigh, 23 Aibreán.
4. Freagair na ceisteanna ag tosú ar leathanach 4 do gach
duine atá i láthair oíche Dé Domhnaigh, 23 Aibreán.
5. Freagair na ceisteanna ar leathanaigh 22-23 i dtaca le haon
bhaill den teaghlach atá as baile go sealadach oíche Dé
Domhnaigh, 23 Aibreán.
6. Sínigh an dearbhú ar an leathanach cúil.
Bíodh an fhoirm chomhlánaithe ullamh agat le bailiú.
Glaofaidh an tÁiritheoir ort chun an fhoirm chomhlánaithe
Dhaonáirimh a bhailiú Dé Luain, 24 Aibreán, nó go luath ina
dhiaidh sin agus cabhróidh sé/sí leat má tá deacrachtaí agat
léi. Má tharlaíonn sé, ar aon chúis, nach bhfuil an fhoirm agatsa
bailithe faoi Dé Luain, 22 Bealtaine 2006, cuir ar ais í chuig ár
seoladh SAORPHOIST ag An Phríomh-Oifig Staidrimh, Bosca
Poist 2006, SAORPHOST, Sord, Co. Átha Cliath.
D'úsáid oifige amháin
Uimhir Tí agus Ainm Sráide/Bhaile Fearainn
Cód
Contae
Lch 1
Cód Limistéir
Áirimh
Cód Toghcheantair
Cód Sráide/
Bhaile Fearainn
Uimhir D
Líon Daoine I LÁTHAIR
Fireannaigh Baineannaigh
Iomlán
Daoine
AS LÁTHAIR
FOIRM THEAGHLAIGH
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Page 3
Conas an Fhoirm Dhaonáirimh a chomhlánú
Úsáidtear peann DUBH nó GORM le do thoil
SAMPLA
Comhlánaigh an fhoirm seo ag úsáid
peann DUBH nó GORM, le do thoil.
Nuair a iarrtar ort freagra a
scríobh úsáid
BLOCLITREACHA le do thoil
Cuir tic sna boscaí mar seo:
agus fág spás amháin idir
Má dhéanann tú earráid:
gach focal. Lean ar aghaidh
1
Líon an bosca mar seo:
Sa tseachtain chuig líne eile mura rachaidh
focal ar líne amháin, mar a
Sa mhí
sa cheann ceart mar seo: 2
dhéantar sa sampla.
H1
Cén cineál cóiríochta ina
gcónaíonn do theaghlach?
H3
1
Scoite
2
Leathscoite
3
Neamhscoite (lena n-áirítear cinn
sraithe tithe neamhscoite)
4
I mbloc saindéanta árasán
5
Mar chuid de theach athchóirithe nó
foirgneamh tráchtála
Úinéir i seilbh agus aisíocaíochtaí
iasachta nó morgáiste á ndéanamh
2
Úinéir i seilbh gan aon aisíocaíochtaí
iasachta ná morgáiste á ndéanamh
Á cheannach ó Údarás Áitiúil faoi
Scéim Cheannaigh le haghaidh
Tionóntaí
3
4
Ar cíos ó Údarás Áitiúil
5
Ar cíos ó Eagraíocht Deonach
6
Ar cíos gan troscán seachas ó
Údarás Áitiúil nó Eagraíocht Deonach
7
Ar cíos le troscán nó le troscán i bpáirt
seachas ó Údarás Áitiúil nó
Eagraíocht Deonach
8
I seilbh saor ó chíos (airíoch,
oifigeach cuideachta, srl.)
H4
Seomra suí/leapa:
Seomra suí/leapa (le cuid de na háiseanna
roinnte, mar shampla leithreas)
Carbhán nó struchtúr soghluaiste nó
sealadach eile
Cén bhliain inár céadtógadh
do theach nó foirgneamh eile
ina bhfuil do chóiríocht?
H7
Cén cineál soláthair uisce
phíobaithe atá sa chóiríocht agat?
i mbosca amháin.
1
Nasc le Príomhlíonra Poiblí
2
Nasc le Grúp-Scéim Uisce le foinse
soláthair Údaráis Áitiúil
Nasc le Grúp-Scéim Uisce le foinse
phríobháideach soláthair (e.g. poll
tóraíochta, loch, srl.)
3
Roimh 1919
2
1919 – 1940 araon san áireamh
3
1941 – 1960 araon san áireamh
4
1961 – 1970 araon san áireamh
5
1971 – 1980 araon san áireamh
6
1981 – 1990 araon san áireamh
7
1991 – 1995 araon san áireamh
8
1996 – 2000 araon san áireamh
9
2001 nó ina dhiaidh
4
5
H8
H
!
N
Nasc le foinse phríobháideach eile
(e.g. tobar, loch, umar báistí, srl.)
Gan aon soláthar uisce phíobaithe
Cén cineál saoráide séarachais
atá sa chóiríocht?
i mbosca amháin.
1
Scéim séarachais phoiblí
2
Umar seipteach indibhidiúil
3
Córas indibhidiúil cóireála eile
seachas umar seipteach
4
Saoráid séarachais eile
5
Gan aon saoráid séarachais
H9
Cé mhéad gluaisteán nó veain atá ar
úinéireacht nó ar fáil le húsáid ag ball
amháin nó níos mó den teaghlach?
Áirigh aon ghluaisteán nó veain cuideachta
má tá sé ar fáil le haghaidh úsáide príobháidí.
i mbosca amháin.
sa bhosca cuí.
1
Sa tseachtain
2
Sa mhí
1
Ceann amháin
3
Sa bhliain
2
Dhá cheann
3
Trí cinn
4
Ceithre cinn nó níos mó
NÁ comhair seomraí folctha, leithris,
cistinéid, seomraí acraí, seomraí comhairle,
oifigí, siopaí, hallaí ná léibhinn, ná seomraí
nach féidir a úsáid ach amháin le haghaidh
stórála ar nós cupard.
5
Níl aon cheann
Comhair gach seomra eile, mar shampla,
cistiní, seomraí teaghlaigh, seomraí codlata,
grianáin a suítear iontu agus seomraí staidéir.
1
Tá
2
Níl
Má tá dhá sheomra iompaithe i seomra
amháin, comhair mar sheomra amháin iad.
H11
H5
an bhliain inár céadtógadh é fiú má
tá athrú, athchóiriú nó fairsingiú déanta
air ó shin.
1
Má tá do chóiríocht ar cíos, cé
mhéad cíosa a íocann do
theaghlach?
Cuir isteach méid chuig an Euro is gaire.
€
Struchtúr soghluaiste nó sealadach:
Lch 2
Cad é an cineál seilbhe ar
chóiríocht do theaghlaigh?
1
Árasán (dúbailte san áireamh)
glanscartha:
H2
SHÉALA
G I
I
A
Á
N
H
Á M
L
H SA
M A
O L
C EO
Á
N AR
M
Teach iomlán nó bungaló atá:
7
NUA
I NN
i mbosca amháin.
i mbosca amháin.
6
Más áit eile THAR LEAR, scríobh
isteach AN TÍR.
Cuir tic sna boscaí mar seo
Ceisteanna maidir le do chóiríocht
TOSNAIGH ANSEO
Cad í d'áit bhreithe?
Cé mhéad seomra atá agat le
húsáid ag do theaghlach amháin?
H10 An bhfuil ríomhaire pearsanta
(RP) sa teaghlach?
1
‘Tᒠmá tá rochtain ar an
idirlíon sa bhaile.
Tá, le ceangal banda leathan
2
Tá, le ceangal eile
3
Níl
Líon seomraí
H6
An bhfuil téamh lárnach sa
chóiríocht?
1
’Tᒠmá tá téamh lárnach agat i gcuid
de na seomraí nó iontu ar fad cuma
má úsáidtear nó nach n-úsáidtear é.
Tá
2
Níl
An bhfuil rochtain ag do
theaghlach ar an Idirlíon?
H12
Téigh go dtí an chéad leathanach eile
FOIRM THEAGHLAIGH
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Page 6
Daoine i láthair sa teach oíche Dé Domhnaigh 23 Aibreán
Liostaigh gach duine a chaith oíche Dé Domhnaigh 23 Aibreán, sa teaghlach nó a tháinig go dtí é an mhaidin ina
dhiaidh sin agus nár áiríodh aon áit eile.
ÁIRIGH
gach duine beo ag meán oíche, Dé Domhnaigh 23 Aibreán.
daoine atá ag fanacht go sealadach sa teaghlach.
NÁ hÁIRIGH
mic léinn atá as baile oíche Dé Domhnaigh, 23 Aibreán; ba chóir iad a liostáil mar as láthair i Liosta 2 thíos.
babaithe a saolaíodh i ndiaidh mheán oíche, Dé Domhnaigh 23 Aibreán.
aon duine atá as baile go sealadach oíche Dé Domhnaigh, 23 Aibreán. Ba chóir na daoine sin a liostáil mar as láthair i
Liosta 2 thíos, áfach.
LIOSTA 1
Uimhir Duine
1
2
3
4
5
6
Daoine I LÁTHAIR sa teach oíche Dé Domhnaigh 23 Aibreán
Céad ainm agus sloinne
H
!
N
Freagair ceisteanna
a bhaineann le gach
duine i láthair sa
teaghlach Dé
Domhnaigh, 23
Aibreán, ag tosú ar
Lch. 4.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
Má tá níos mó ná seisear i láthair sa teaghlach oíche Dé Domhnaigh, 23 Aibreán, beidh Foirm Phearsan
Aonair ag teastáil uait do gach duine breise. Iarr comhairle ar d'Áiritheoir.
7
8
9
10
11
12
Freagair ceisteanna
a bhaineann le
daoine 7,8,9 &rl ar
Fhoirmeacha
Pearsana Aonair
breise atá ar fáil ó
d'Áiritheoir.
Daoine as baile ón teaghlach go sealadach oíche Dé Domhnaigh, 23 Aibreán
Liostaigh aon bhaill den teaghlach a mbíonn cónaí orthu de ghnáth ag an seoladh seo ach a bhí AS LÁTHAIR oíche
Dé Domhnaigh, 23 Aibreán. Áirigh ach go háirithe mic léinn atá ina gcónaí as baile le linn téarma nach raibh i láthair
oíche Dé Domhnaigh, 23 Aibreán.
LIOSTA 2
Daoine AS BAILE ón teaghlach go sealadach oíche Dé Domhnaigh, 23 Aibreán
Uimhir Duine
Céad ainm agus sloinne
1
2
3
4
5
6
Ní mór duit ceisteanna
a fhreagairt ag tosú ar
Lch. 22 le haghaidh
gach
gnáthchónaitheora atá
liostaithe anseo mar as
láthair ón teaghlach
oíche Dé Domhnaigh,
23 Aibreán.
Má tá níos mó ná 6 ghnáthchónaitheoirí as láthair oíche Dé Domhnaigh 23 Aibreán, iarr comhairle ar
d'Áiritheoir le do thoil.
Freagair na ceisteanna le haghaidh gach duine a bhí i láthair sa teaghlach oíche Dé Domhnaigh,
23 Aibreán, san ord céanna mar a liostaítear ar Liosta 1 thuas ag tosú ar Lch. 4.
Lch 3
FOIRM THEAGHLAIGH
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2
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Page 13
Cuir tic sna boscaí mar seo
Duine 1
Cad is ainm duit? (Duine 1)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Fireann
1
2
Baineann
12
Ní bhaineann ceist an ghaoil le
Duine 1.
3
Áit eile THAR LEAR, sonraigh an TÍR
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Duine ar bith
An bhfuil Gaeilge labhartha agat?
Freagair má tá tú 3 bliana d'aois nó níos sine.
1
Tá
2
Níl
MÁ 'Tá', an labhraíonn tú Gaeilge?
GACH bosca cuí.
8
Cá raibh gnáthchónaí ort bliain ó
shin?
Go laethúil, sa chóras oideachais
2
Go laethúil, taobh amuigh den chóras
oideachais
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
Freagair má tá tú bliain amháin d'aois nó níos sine.
Seoladh CÉANNA
3
Go seachtainiúil
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
Ní chomh minic sin
5
Ní labhraíonn riamh í
3
Cad é do dháta breithe?
Lá
5
Mí
9
Bliain
Áit eile THAR LEAR, sonraigh an TÍR
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
Caitliceach
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
14
A
2
3
10
3
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 4
1
B
Cad é do stádas pósta reatha?
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
1
Más áit eile THAR LEAR é, sonraigh
an TÍR.
2
i mbosca amháin.
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
an TÍR inár chónaigh tú go deireanach.
1
Cén creideamh atá agat?
1
AGUS
6
!
N
1
13
4
H
1
4
5
C
6
2
Pósta (an chéad phósadh)
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
7
Cine Geal
Éireannach
Ball de Lucht Taistil na hÉireann
Aon chúlra Geal eile
Cine Gorm nó Éireannach Gorm
Afraiceach
Aon chúlra Gorm eile
Áiseach nó Áiseach Éireannach
Síneach
Aon chúlra Áiseach eile
Eile, cúlra measctha san áireamh
Eile, sonraigh
FOIRM THEAGHLAIGH
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Page 16
Cuir tic sna boscaí mar seo
Duine 1 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Níl
Tá
2
1
(c) Míchumas foghlamtha nó
intleachtúil
(d) Riocht síceolaíoch nó
tochtach
Tá
1
Níl
2
Tá
Níl
2
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
Tá
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
19
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
1
(b) Gléasadh, folcadh nó
dul timpeall laistigh
den bhaile
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
Ciliméadair
2
Ní
Bíonn bhíonn
1
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
Nóiméid
2
2
20
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
7
H
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
5
Ríomhaireacht
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
2
Rothar
4
3
Bus, mionbhus nó cóiste
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
Traein, DART nó LUAS
5
Ní sholáthraíonn
4
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 5
23
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Níl
2
1
18
Scríobh i mBLOCLITREACHA
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
FOIRM THEAGHLAIGH
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Page 19
25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
H
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Nó eile,
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
NÁ hÚSÁID téarmaí ginearálta mar
Úsáid téarmaí beachta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
1
27
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
i mbosca amháin.
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
Duine 1 - ar lean
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 6
34
Freagair ceisteanna do Dhuine 2 ag tosú ar an gcéad leathanach eile.
Muna bhfuil ach duine amháin i láthair sa teaghlach ar oíche an 23
Aibreán,
Téigh ar aghaidh chuig lth 22
FOIRM THEAGHLAIGH
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1
2
15:12
Page 16
Cuir tic sna boscaí mar seo
Duine 2
Cad is ainm duit? (Duine 2)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Duine ar bith
Fireann
1
2
Baineann
12
Cén gaol atá agat le Duine 1?
3
Áit eile THAR LEAR, sonraigh an TÍR
Féach sampla ar an leathanach cúil.
i mbosca amháin.
Gaol ag DUINE 2 le
Duine
1
Fear céile nó bean chéile
1
Páirtí
2
Mac nó iníon
4
Deartháir nó deirfiúr
5
Máthair nó athair
6
Leasmháthair/leasathair
7
Cliamhain nó banchliamhain
8
Garleanbh
Gaol eile
9
5
Tá
2
Níl
GACH bosca cuí.
8
1
Cá raibh gnáthchónaí ort bliain
ó shin?
Freagair má tá tú bliain amháin d'aois nó níos sine.
Mí
3
Go seachtainiúil
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
Ní chomh minic sin
5
Ní labhraíonn riamh í
13
3
Áit eile THAR LEAR, sonraigh an TÍR
9
Bliain
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
10
3
Cén creideamh atá agat?
i mbosca amháin.
1
Caitliceach
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
Más áit eile THAR LEAR é, sonraigh
an TÍR.
2
!
N
Seoladh CÉANNA
an TÍR inár chónaigh tú go deireanach.
1
Go laethúil, taobh amuigh den chóras
oideachais
1
14
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 7
1
A
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cine Geal
1
Éireannach
2
Ball de Lucht Taistil na hÉireann
3
Aon chúlra Geal eile
B
Cad é do stádas pósta reatha?
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
AGUS
6
Go laethúil, sa chóras oideachais
H
2
11
Cad é do dháta breithe?
Lá
1
MÁ 'Tá', an labhraíonn tú Gaeilge?
10
Duine nach gaol
(lena n-áirítear páiste altrama)
4
An bhfuil Gaeilge labhartha agat?
Freagair má tá tú 3 bliana d'aois nó níos sine.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
3
Leasleanbh
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Cine Gorm nó Éireannach Gorm
4
Afraiceach
5
Aon chúlra Gorm eile
C
Áiseach nó Áiseach Éireannach
6
Síneach
Aon chúlra Áiseach eile
2
Pósta (an chéad phósadh)
7
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
Eile, cúlra measctha san áireamh
Eile, sonraigh
FOIRM THEAGHLAIGH
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Cuir tic sna boscaí mar seo
Duine 2 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
1
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Tá
(c) Míchumas foghlamtha nó
intleachtúil
(d) Riocht síceolaíoch nó
tochtach
Níl
2
Tá
1
Níl
2
Níl
Tá
2
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
Tá
1
18
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
Níl
2
19
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
23
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
1
Ciliméadair
2
(b) Gléasadh, folcadh nó
Ní
Bíonn bhíonn
dul timpeall laistigh
den bhaile
1
2
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
2
Nóiméid
20
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Scríobh i mBLOCLITREACHA
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
5
Ríomhaireacht
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
2
Rothar
4
3
Bus, mionbhus nó cóiste
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
Traein, DART nó LUAS
5
Ní sholáthraíonn
4
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 8
7
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
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Duine 2 - ar lean
25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
NÁ hÚSÁID téarmaí ginearálta mar
Úsáid téarmaí beachta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Nó eile,
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
i mbosca amháin.
27
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 9
34
Freagair ceisteanna do Dhuine 3 ag tosú ar an gcéad leathanach eile.
Muna bhfuil ach beirt i láthair sa teaghlach ar oíche an 23 Aibreán,
Téigh ar aghaidh chuig lth 22
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Cuir tic sna boscaí mar seo
Duine 3
Cad is ainm duit? (Duine 3)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Fireann
1
2
Baineann
12
Cén gaol atá agat le Daoine 1
agus 2?
Féach sampla ar an leathanach cúil.
i mbosca amháin do gach duine.
Gaol ag DUINE 3 le
Daoine
1
2
Fear céile nó bean chéile
1
Páirtí
2
Mac nó iníon
4
Deartháir nó deirfiúr
Máthair nó athair
Cliamhain nó banchliamhain
8
9
5
Mí
Tá
2
Níl
1
Cá raibh gnáthchónaí ort bliain
ó shin?
2
Freagair má tá tú bliain amháin d'aois nó níos sine.
1
Seoladh CÉANNA
3
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
5
13
3
Áit eile THAR LEAR, sonraigh an TÍR
9
Bliain
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
Más áit eile THAR LEAR é, sonraigh
an TÍR.
10
2
3
Go seachtainiúil
Ní chomh minic sin
Ní labhraíonn riamh í
Cén creideamh atá agat?
i mbosca amháin.
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
an TÍR inár chónaigh tú go deireanach.
1
!
N
Go laethúil, taobh amuigh den chóras
oideachais
Caitliceach
14
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 10
1
A
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cine Geal
1
Éireannach
2
Ball de Lucht Taistil na hÉireann
3
Aon chúlra Geal eile
B
Cad é do stádas pósta reatha?
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
AGUS
6
H
Go laethúil, sa chóras oideachais
1
11
Cad é do dháta breithe?
Lá
8
10
Duine nach gaol
(lena n-áirítear páiste altrama)
4
1
GACH bosca cuí.
6
7
Gaol eile
An bhfuil Gaeilge labhartha agat?
Freagair má tá tú 3 bliana d'aois nó níos sine.
MÁ 'Tá', an labhraíonn tú Gaeilge?
5
Leasmháthair/leasathair
Garleanbh
Áit eile THAR LEAR, sonraigh an TÍR
Duine ar bith
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
3
Leasleanbh
3
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Cine Gorm nó Éireannach Gorm
4
Afraiceach
5
Aon chúlra Gorm eile
C
Áiseach nó Áiseach Éireannach
6
Síneach
Aon chúlra Áiseach eile
2
Pósta (an chéad phósadh)
7
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
Eile, cúlra measctha san áireamh
Eile, sonraigh
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Cuir tic sna boscaí mar seo
Duine 3 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Tá
(d) Riocht síceolaíoch nó
tochtach
Níl
2
1
(c) Míchumas foghlamtha nó
intleachtúil
Tá
Níl
2
1
Tá
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
Níl
2
Tá
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
19
23
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
1
(b) Gléasadh, folcadh nó
dul timpeall laistigh
den bhaile
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Ciliméadair
2
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
Nóiméid
2
Ní
Bíonn bhíonn
1
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
2
20
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Níl
2
1
18
Scríobh i mBLOCLITREACHA
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
5
Ríomhaireacht
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
2
Rothar
4
3
Bus, mionbhus nó cóiste
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
Traein, DART nó LUAS
5
Ní sholáthraíonn
4
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 11
7
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
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25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
Úsáid téarmaí beachta mar
NÁ hÚSÁID téarmaí ginearálta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
H
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Nó eile,
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
i mbosca amháin.
27
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
Duine 3 - ar lean
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 12
34
Freagair ceisteanna do Dhuine 4 ag tosú ar an gcéad leathanach eile.
Muna bhfuil ach triúr i láthair sa teaghlach ar oíche an 23 Aibreán,
Téigh ar aghaidh chuig lth 22
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2
15:12
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Cuir tic sna boscaí mar seo
Duine 4
Cad is ainm duit? (Duine 4)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Fireann
1
2
Baineann
12
Cén gaol atá agat le Daoine 1,
2 agus 3?
Féach sampla ar an leathanach cúil.
i mbosca amháin do gach duine.
Gaol ag DUINE 4 le
Daoine
1
2
3
Fear céile nó bean chéile
1
Páirtí
2
Mac nó iníon
Máthair nó athair
Cliamhain nó banchliamhain
8
8
Cá raibh gnáthchónaí ort bliain
ó shin?
5
1
Go laethúil, sa chóras oideachais
2
Go laethúil, taobh amuigh den chóras
oideachais
Go seachtainiúil
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
Ní chomh minic sin
5
Ní labhraíonn riamh í
Áit eile THAR LEAR, sonraigh an TÍR
10
9
Bliain
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
Más áit eile THAR LEAR é, sonraigh
an TÍR.
10
2
3
Cén creideamh atá agat?
i mbosca amháin.
1
Caitliceach
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
an TÍR inár chónaigh tú go deireanach.
1
!
N
3
14
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 13
1
A
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cine Geal
1
Éireannach
2
Ball de Lucht Taistil na hÉireann
3
Aon chúlra Geal eile
B
Cad é do stádas pósta reatha?
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
AGUS
6
H
Seoladh CÉANNA
3
9
Mí
Níl
13
Cad é do dháta breithe?
Lá
2
1
11
Duine nach gaol
(lena n-áirítear páiste altrama)
4
Tá
GACH bosca cuí.
6
7
Gaol eile
1
MÁ 'Tá', an labhraíonn tú Gaeilge?
5
Leasmháthair/leasathair
Garleanbh
An bhfuil Gaeilge labhartha agat?
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
4
Deartháir nó deirfiúr
Áit eile THAR LEAR, sonraigh an TÍR
Duine ar bith
Freagair má tá tú 3 bliana d'aois nó níos sine.
Freagair má tá tú bliain amháin d'aois nó níos sine.
3
Leasleanbh
3
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Cine Gorm nó Éireannach Gorm
4
Afraiceach
5
Aon chúlra Gorm eile
C
Áiseach nó Áiseach Éireannach
6
Síneach
Aon chúlra Áiseach eile
2
Pósta (an chéad phósadh)
7
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
Eile, cúlra measctha san áireamh
Eile, sonraigh
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Cuir tic sna boscaí mar seo
Duine 4 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Tá
(d) Riocht síceolaíoch nó
tochtach
Níl
2
1
(c) Míchumas foghlamtha nó
intleachtúil
Tá
Níl
2
1
Tá
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
18
Níl
2
Tá
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
Níl
19
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
1
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
Ciliméadair
2
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
2
Nóiméid
20
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
(b) Gléasadh, folcadh nó
Ní
Bíonn bhíonn
dul timpeall laistigh
den bhaile
1
2
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
H
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
7
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
4
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
5
Ríomhaireacht
5
Ní sholáthraíonn
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
2
Rothar
3
Bus, mionbhus nó cóiste
4
Traein, DART nó LUAS
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 14
23
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
2
1
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Scríobh i mBLOCLITREACHA
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
FOIRM THEAGHLAIGH
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Duine 4 - ar lean
25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
Úsáid téarmaí beachta mar
NÁ hÚSÁID téarmaí ginearálta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
H
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
G I
I
A
Á
N
H
Á M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Nó eile,
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
i mbosca amháin.
27
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 15
34
Freagair ceisteanna do Dhuine 5 ag tosú ar an gcéad leathanach eile.
Muna bhfuil ach ceathrar i láthair sa teaghlach ar oíche an 23 Aibreán,
Téigh ar aghaidh chuig lth 22
FOIRM THEAGHLAIGH
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2
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Cuir tic sna boscaí mar seo
Duine 5
Cad is ainm duit? (Duine 5)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Fireann
1
2
Baineann
12
Cén gaol atá agat le Daoine 1,
2, 3 agus 4?
Féach sampla ar an leathanach cúil.
i mbosca amháin do gach duine.
Gaol ag DUINE 5 le
Daoine
1 2 3 4
Fear céile nó bean chéile
Páirtí
1
4
Deartháir nó deirfiúr
Máthair nó athair
Cliamhain nó banchliamhain
8
8
5
2
1
Seoladh CÉANNA
3
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
3
9
Áit eile THAR LEAR, sonraigh an TÍR
10
Mí
Níl
5
13
Cad é do dháta breithe?
Lá
2
1
Cá raibh gnáthchónaí ort bliain
ó shin?
11
Duine nach gaol
(lena n-áirítear páiste altrama)
4
Tá
GACH bosca cuí.
6
7
Gaol eile
1
MÁ 'Tá', an labhraíonn tú Gaeilge?
5
Leasmháthair/leasathair
Garleanbh
9
Bliain
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
Más áit eile THAR LEAR é, sonraigh
an TÍR.
10
2
3
!
N
Go laethúil, taobh amuigh den chóras
oideachais
Go seachtainiúil
Ní chomh minic sin
Ní labhraíonn riamh í
Cén creideamh atá agat?
i mbosca amháin.
Caitliceach
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
an TÍR inár chónaigh tú go deireanach.
1
H
Go laethúil, sa chóras oideachais
1
14
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 16
1
A
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cine Geal
1
Éireannach
2
Ball de Lucht Taistil na hÉireann
3
Aon chúlra Geal eile
B
Cad é do stádas pósta reatha?
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
AGUS
6
An bhfuil Gaeilge labhartha agat?
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
3
Leasleanbh
Áit eile THAR LEAR, sonraigh an TÍR
Duine ar bith
Freagair má tá tú 3 bliana d'aois nó níos sine.
Freagair má tá tú bliain amháin d'aois nó níos sine.
2
Mac nó iníon
3
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Cine Gorm nó Éireannach Gorm
4
Afraiceach
5
Aon chúlra Gorm eile
C
Áiseach nó Áiseach Éireannach
6
Síneach
Aon chúlra Áiseach eile
2
Pósta (an chéad phósadh)
7
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
Eile, cúlra measctha san áireamh
Eile, sonraigh
FOIRM THEAGHLAIGH
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Cuir tic sna boscaí mar seo
Duine 5 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
1
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Tá
(c) Míchumas foghlamtha nó
intleachtúil
(d) Riocht síceolaíoch nó
tochtach
Níl
2
Tá
1
Níl
2
Níl
Tá
2
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
Tá
1
18
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
Níl
2
23
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
19
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
1
(b) Gléasadh, folcadh nó
dul timpeall laistigh
den bhaile
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Ciliméadair
2
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
Nóiméid
2
Ní
Bíonn bhíonn
1
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
2
20
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Scríobh i mBLOCLITREACHA
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
5
Ríomhaireacht
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
2
Rothar
4
3
Bus, mionbhus nó cóiste
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
Traein, DART nó LUAS
5
Ní sholáthraíonn
4
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 17
7
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
FOIRM THEAGHLAIGH
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25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
Úsáid téarmaí beachta mar
NÁ hÚSÁID téarmaí ginearálta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
H
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
G I
I
A
Á
N
H
Á M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Nó eile,
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
i mbosca amháin.
27
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
Duine 5 - ar lean
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 18
34
Freagair ceisteanna do Dhuine 6 ag tosú ar an gcéad leathanach eile.
Muna bhfuil ach cúigear i láthair sa teaghlach ar oíche an 23 Aibreán,
Téigh ar aghaidh chuig lth 22
FOIRM THEAGHLAIGH
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2
14:53
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Cuir tic sna boscaí mar seo
Duine 6
Cad is ainm duit? (Duine 6)
Céad ainm agus sloinne
7
Cá bhfuil gnáthchónaí ort?
1
ANSEO ag an seoladh seo
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
Gnéas
11
Fireann
1
2
Baineann
12
Cén gaol atá agat le Daoine 1,
2, 3 agus 4?
Féach sampla ar an leathanach cúil.
i mbosca amháin do gach duine.
Gaol ag DUINE 6 le
Daoine
1 2 3 4
Fear céile nó bean chéile
1
Páirtí
2
Mac nó iníon
Máthair nó athair
Cliamhain nó banchliamhain
8
8
5
2
1
Seoladh CÉANNA
3
2
Áit eile in ÉIRINN (lena n-áirítear
Tuaisceart Éireann), sonraigh an
CONTAE
4
3
9
Áit eile THAR LEAR, sonraigh an TÍR
10
Mí
Níl
5
13
Cad é do dháta breithe?
Lá
2
1
Cá raibh gnáthchónaí ort bliain
ó shin?
11
Duine nach gaol
(lena n-áirítear páiste altrama)
4
Tá
GACH bosca cuí.
6
7
Gaol eile
1
MÁ 'Tá', an labhraíonn tú Gaeilge?
5
Leasmháthair/leasathair
Garleanbh
9
Bliain
Ar chónaigh tú lasmuigh de
Phoblacht na hÉireann ar feadh
tréimhse leanúnaí de bhliain nó
níos mó?
Cad í d'áit bhreithe?
Tabhair áit chónaithe do mháthar nuair
a saolaíodh thú.
Más ÉIRE (lena n-áirítear Tuaisceart
Éireann) an freagra, sonraigh an CONTAE.
1
Chónaigh
2
Níor chónaigh
MÁ 'Chónaigh', sonraigh an BHLIAIN
inár tháinig tú chun cónaithe i bPoblacht
na hÉireann den uair dheireanach
Más áit eile THAR LEAR é, sonraigh
an TÍR.
10
2
3
H
!
N
Go laethúil, taobh amuigh den chóras
oideachais
Go seachtainiúil
Ní chomh minic sin
Ní labhraíonn riamh í
Cén creideamh atá agat?
i mbosca amháin.
Caitliceach
2
Eaglais na hÉireann
3
Preispitéireach
4
Modhach
5
Ioslamachas
6
Eile, sonraigh do CHREIDEAMH
7
Níl aon chreideamh
Freagair má tá tú bliain amháin d'aois nó
níos sine agus gnáthchónaí in Éirinn ort.
an TÍR inár chónaigh tú go deireanach.
1
Go laethúil, sa chóras oideachais
1
14
Cén Náisiúntacht atá agat?
Má tá níos mó ná náisiúntacht amháin
agat, luaigh gach ceann díobh.
Éireannach
NÁISIÚNTACHT eile, sonraigh
Gan aon Náisiúntacht
Lch 19
1
A
Freagair má tá tú 15 bliana d'aois nó
níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Cine Geal
1
Éireannach
2
Ball de Lucht Taistil na hÉireann
3
Aon chúlra Geal eile
B
Cad é do stádas pósta reatha?
Cén grúpa eitneach nó cultúr lena
mbaineann tú?
Roghnaigh rannóg AMHÁIN ó A go D,
sa bhosca cuí ansin.
AGUS
6
An bhfuil Gaeilge labhartha agat?
G I
I
A
Á
N
H
Á M
L
H SA
M A
O L
C EO
Á
N AR
M
4
Deartháir nó deirfiúr
Áit eile THAR LEAR, sonraigh an TÍR
Duine ar bith
Freagair má tá tú 3 bliana d'aois nó níos sine.
Freagair má tá tú bliain amháin d'aois nó níos sine.
3
Leasleanbh
3
Cé mhéid leanaí a saolaíodh duit?
Do mhná amháin an cheist seo.
Scríobh isteach an méid leanaí a saolaíodh beo.
1
3
Scríobh i mBLOCLITREACHA
Cine Gorm nó Éireannach Gorm
4
Afraiceach
5
Aon chúlra Gorm eile
C
Áiseach nó Áiseach Éireannach
6
Síneach
Aon chúlra Áiseach eile
2
Pósta (an chéad phósadh)
7
3
Athphósta (i ndiaidh Baintreachais)
D
4
Athphósta (i ndiaidh Colscartha/Neamhnithe)
8
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
7
Baintreach
Eile, cúlra measctha san áireamh
Eile, sonraigh
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Cuir tic sna boscaí mar seo
Duine 6 - ar lean
15
An bhfuil aon cheann de na riochtaí
fadtéarmacha seo a leanas ort?
(a) Daille, bodhaire, nó
mórlagú amhairc nó
éisteachta
Tá
(b) Riocht a bhacann go
mór bunghníomhaíocht
fhisiceach amháin nó
níos mó mar shiúl, dul
suas staighre, síneadh,
ardú nó iompar
Níl
Tá
2
1
(c) Míchumas foghlamtha nó
intleachtúil
(d) Riocht síceolaíoch nó
tochtach
Tá
1
Níl
2
Tá
Níl
2
1
(e) Eile, aon droch thinneas
san áireamh
16
Níl
2
1
18
Tá
1
Roimh 06:30
2
06:31 - 07:00
3
07:01 - 07:30
4
07:31 - 08:00
5
08:01 - 08:30
6
08:31 - 09:00
7
09:01 - 09:30
8
I ndiaidh 09:30
9
Ní bhaineann le hábhar
Níl
19
MÁ d'fhreagair tú 'Tá' i dtaobh aon
riocht i gCeist 15, an mbíonn aon
deacracht agat aon cheann de na
gníomhaíochtaí seo a leanas a
dhéanamh?
1
(c) Dul amach ón mbaile
i d'aonar chun
siopadóireacht a
dhéanamh nó chun
cuairt a thabhairt ar
an dochtúir
Ciliméadair
2
(d) Obair a dhéanamh i
bpost nó i ngnó nó
freastal a dhéanamh
ar scoil nó coláiste
Ní
Bíonn bhíonn
1
2
Ní
Bíonn bhíonn
1
2
Nóiméid
20
i mbosca amháin, don chuid is
faide, de réir achair, de do ghnáththuras chun oibre, chun scoile nó
chun coláiste.
Má tá tú faoi 15 bliana d'aois,
Téigh ar aghaidh chuig C34
ar an gcéad leathanach eile
21
(e) Páirt a ghlacadh in
Ní
ngníomhaíochtaí eile, Bíonn bhíonn
mar shampla
1
2
siamsaíocht nó córas
iompair a úsáid
Cén ghnáthchóir thaistil chun oibre,
chun scoile nó chun coláiste atá agat?
Cén t-achar atá an turas ón
mbaile chun oibre, chun
scoile nó chun coláiste agus
cá fhad a thógann sé de
ghnáth?
Sonraigh an t-achar go dtí an
ciliméadar is gaire agus fad an
turais i nóiméid.
(b) Gléasadh, folcadh nó
Ní
Bíonn bhíonn
dul timpeall laistigh
den bhaile
1
2
An soláthraíonn tú cúnamh
pearsanta rialta gan phá do chara
nó do bhall den teaghlach a bhfuil
breoiteacht, fadhb shláinte nó
míchumas fadtéarmach aige/aici?
Áirigh fadhbanna de bharr seanaoise.
Áirítear i gcúnamh pearsanta
cúnamh le buntascanna mar
bheathú nó gléasadh.
Cad é an leibhéal is airde oideachais
(lánaimseartha nó páirtaimseartha) atá
críochnaithe agat go dtí seo?
i mbosca amháin.
1
Gan oideachas foirmiúil
2
Bunoideachas
3
Dara Leibhéal
Iar-bhunoideachas íseal:
Teastas Sóisearach/Meán-Teist/Teastas Grúpa, ÓLeibhéil/GCSEanna, Bunteastas CNCG, Teastas Oiliúna
Bunscileanna nó a choibhéis
4
Iar-bhunoideachas ard:
Ardteistiméireacht (lena n-áirítear Cláir Fheidhmeacha
agus Gairmchúrsaí), A-Leibhéil, Teastas CNCG Leibhéal
1 nó a choibhéis
5
Cáilíocht Theicniúil nó Gairmchúrsa:
6
Iar-bhunoideachas ard agus Cáilíocht
Theicniúil nó Gairmchúrsa
H
Printíseacht Chríochnaithe, Teastas CNCG Leibhéal 2/3,
Teastas/Dioplóma Theagasc nó a choibhéis
7
!
N
Tríú Leibhéal
Cáilíocht nach cáilíocht chéime í:
Teastas Náisiúnta, Dioplóma CNCO/Institiúid
Teicneolaíochta nó a choibhéis, Dioplóma Altranais
8
Bunchéim ollscoile (Céim Bhaitsiléara Tríú Leibhéil)
9
Cáilíocht ghairmiúil (de stádas céime, ar
a laghad)
10
Céim agus cáilíocht ghairmiúil
11
Teastas nó Dioplóma iarchéime
12
Iarchéim (Máistreacht)
13
Dochtúireacht (Ph.D)
24
An bhfuil aon cháilíocht(aí) TRÍÚ
LEIBHÉIL agat a bhain tú amach i
ndiaidh 2 bhliain staidéir nó níos mó?
1
Tá
2
Níl
MÁ 'Tá', tabhair le fios an príomhréimse/
na príomhréimsí ábhair ina bhfuil an
cháilíocht/na cáilíochtaí sin agat.
i nGACH bosca a bhaineann leis seo.
1
Oideachas
2
Na Dáin agus Ealaíona
(lena n-áirítear Teangacha
Eachtracha, Stair, Fealsúnacht, Mínealaíona, Ceol agus
Ealaíona Léirfheidhmeacha, Dearadh)
1
Soláthraíonn, 1-14 uair an chloig
sa tseachtain
2
Soláthraíonn, 15-28 n-uair an
chloig sa tseachtain
3
Eolaíochtaí Sóisialta/Gnó/Dlí
3
Soláthraíonn, 29-42 uair an chloig
sa tseachtain
4
Eolaíocht Bheatha, Eolaíocht Fhisiciúil,
Matamaitic agus Staitisticí
4
Soláthraíonn, 43 uair an chloig
sa tseachtain nó níos mó
5
Ríomhaireacht
5
Ní sholáthraíonn
6
Innealtóireacht, Déantúsaíocht agus Tógáil
7
Talmhaíocht agus Tréidliacht
8
Sláinte
9
Seirbhísí Sóisialta (lena n-áirítear Cúram Leanaí
10
Seirbhísí (lena n-áirítear Óstánaíocht agus Lónadóireacht,
1
De shiúl na gcos
2
Rothar
3
Bus, mionbhus nó cóiste
4
Traein, DART nó LUAS
5
Gluaisrothar nó scútar
6
Gluaisteán (tiománaí)
7
Gluaisteán (paisinéir)
1
Tá
8
Leoraí nó veain
2
Níl
9
Cóir eile
10
Oibríonn ag baile nó ón mbaile go príomha
11
Ní bhaineann le hábhar
Lch 20
23
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
2
1
(a) Foghlaim, cuimhneamh
Ní
Bíonn bhíonn
nó comhdhíriú
17
Cén t-am de ghnáth a fhágann
tú an baile chun dul chun
oibre, chun scoile nó chun
coláiste?
Scríobh i mBLOCLITREACHA
22
An bhfuil tú scortha den
oideachas lánaimseartha?
MÁ 'Tá', sonraigh an AOIS
nuair a scoireadh.
(lena n-áirítear
Síceolaíocht, Eacnamaíocht, Iriseoireacht, Airgeadas,
Cuntasaíocht)
(lena n-áirítear Ailtireacht)
(lena n-áirítear
Foraoiseacht, Iascach, Garraíodóireacht)
(lena n-áirítear Míochaine, Altranas, Staidéir
Fhiaclóireachta, Teiripe agus Athshlánú, Cógaisíocht)
agus
Seirbhísí Óige, Obair Shóisialta agus Comhairleoireacht)
Spórt, Iompar, Cosaint Chomhshaoil, Slándáil, Sláinte agus
Sábháilteacht Saothair, Seirbhísí Míleata agus Cosanta)
FOIRM THEAGHLAIGH
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Duine 6 - ar lean
25
An bhfuil aon cheann de na rudaí seo a
leanas déanta agat gan phá sa 4
sheachtain deireanach?
29
i nGACH bosca a bhaineann leis seo.
1
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht sóisialta nó charthanach
2
Ag tabhairt cúnamh nó ag obair go deonach
le grúpa cráifeach nó eaglais
3
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht spóirt
4
Ag tabhairt cúnamh nó ag obair go deonach
le heagraíocht pholaitiúil nó chultúrtha
5
Aon ghníomhaíocht eile deonach
6
Gan aon ghníomhaíocht deonach
26
Conas a chuirfeá síos ar do
phríomhstádas faoi láthair?
I ngach cás, cuir síos ar an tslí bheatha ina hiomláine agus go beacht, tabhair
teideal iomlán an phoist.
NÁ hÚSÁID téarmaí ginearálta mar
Úsáid téarmaí beachta mar
BAINISTEOIR SIOPA MIONDÍOLA
Bainisteoir
MÚINTEOIR MEÁNSCOILE
Múinteoir
INNEALTÓIR LEICTREACH
Innealtóir
Ba chóir do Státseirbhísigh agus fostaithe rialtais áitiúil a ngrád a lua e.g.
OIFIGEACH SINSEARACH RIARACHÁIN. Féadfaidh baill den Gharda Síochána
nó den Arm a gcéim a lua. Ba chóir go luafadh múinteoirí a mbrainse múinteoireachta
e.g. BUNMHÚINTEOIR. Ba chóir go dtabharfadh an chléir agus oird chráifeacha
tuairisc iomlán e.g. BEAN RIALTA - BANALTRA GHINEARÁLTA CHLÁRAITHE.
H
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Ag obair le haghaidh íocaíochta nó brabúis
2
Ag lorg oibre rialta don chéad uair
3
Dífhostaithe
4
Mac léinn nó dalta
5
Cúraimí tí/teaghlaigh
6
Scortha ón bhfostaíocht
7
Gan a bheith in ann oibriú de bharr tinnis nó
míchumais bhuan
8
Eile, sonraigh
Má tá tú:
ag obair le haghaidh íocaíochta
nó brabúis (C26 bosca 1),
dífhostaithe (C26 bosca 3),
scortha (C26 bosca 6),
freagair na ceisteanna seo a leanas faoi
do phríomhphost nó faoin bpríomhphost
a bhí agat go deireanach mura bhfuil tú
fostaithe faoi láthair.
!
N
Más feirmeoir nó oibrí feirme thú, sonraigh MÉID na feirme.
Héicteáir
30
Má tá tú scortha,
31
Cad é teideal iomlán na hEagraíochta dá n-oibríonn (dár oibrigh) tú
i do phríomhphost?
Téigh ar aghaidh chuig C34
Má tá (bhí) do ghnólacht féin agat, sonraigh TEIDEAL an ghnólachta.
32
Nó eile,
Cén tslí bheatha atá (a bhí) agat i do phríomhphost?
Sonraigh do phríomh-SHLÍ BHEATHA.
i mbosca amháin.
27
Scríobh i mBLOCLITREACHA
Cuir tic sna boscaí mar seo
1
33
Cad é an seoladh iomlán a n-oibríonn (ar oibrigh) tú aige?
Oibríonn ag baile nó ó bhaile go príomha
2
Gan aon ionad oibre seasta
Cén gnó atá (a bhí) ag d'fhostóir ag an ionad a n-oibríonn (ar
oibrigh) tú i do phríomhphost?
Má tá (bhí) tú féinfhostaithe freagair i dtaca le do ghnó féin.
Déan cur síos ar an bpríomhtháirge nó seirbhís a sholáthraíonn d'fhostóir.
Mar shampla, DÉANANN RÍOMHAIRÍ, DEISÍONN GLUAISTEÁIN,
MEÁNOIDEACHAS, MÓRDHÍOL BIA, DÉANANN CÓGAIS, CONRADHGHLANTACHÁN, FORBAIRT AGUS TACAÍOCHT BOGEARRAÍ.
Téigh ar aghaidh chuig ceist 34.
28
1
An oibríonn (ar oibrigh) tú mar fhostaí
nó an bhfuil (an raibh) tú féinfhostaithe
i do phríomhphost?
Is é do phríomhphost ná an post ina n-oibríonn
(inar oibrigh) tú an chuid is mó uaireanta an
chloig de ghnáth.
Fostaí
2
Féinfhostaithe, le fostaithe íoctha
3
Féinfhostaithe, gan fostaithe íoctha
4
Ag cabhrú le gaol (gan phá ná tuarastal
cinnte á fháil)
Lch 21
34
Má tá níos mó ná seisear i láthair sa teaghlach oíche Dé Domhnaigh
23 Aibreán beidh Foirm Phearsan Aonair uait do gach duine breise.
Iarr ar d'Áiritheoir foirmeacha breise a chur ar fáil duit.
Nó eile,
Téigh ar aghaidh chuig an gcéad leathanach eile.
FOIRM THEAGHLAIGH
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Page 5
Daoine as baile go sealadach ón teaghlach oíche Dé Domhnaigh 23 Aibreán
Freagair ceisteanna A1 go A8 i gcás aon bhall den teaghlach a chónaíonn ag an seoladh seo de ghnáth ach NACH
bhfuil i láthair oíche Dé Domhnaigh, 23 Aibreán. Áirigh ach go háirithe mic léinn atá ina gcónaí as baile le linn tréimhse
téarma NACH bhfuil i láthair ag an seoladh seo oíche Dé Domhnaigh, 23 Aibreán.
A1
A2
Duine as Láthair 1
Cad is ainm don duine?
Céad ainm agus sloinne
A1
A2
Gnéas
Duine as Láthair 2
Cad is ainm don duine?
Céad ainm agus sloinne
A1
A2
Gnéas
Duine as Láthair 3
Cad is ainm don duine?
Céad ainm agus sloinne
Gnéas
1
Fireann
1
Fireann
1
Fireann
2
Baineann
2
Baineann
2
Baineann
A3
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
A3
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
i mbosca amháin.
A3
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
H
i mbosca amháin.
!
N
i mbosca amháin.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
1
Fear céile nó bean chéile
1
Fear céile nó bean chéile
1
Fear céile nó bean chéile
2
Páirtí
2
Páirtí
2
Páirtí
3
Mac nó iníon
3
Mac nó iníon
3
Mac nó iníon
10
GAOL eile, sonraigh
10
GAOL eile, sonraigh
10
GAOL eile, sonraigh
11
A4
Duine nach gaol (lena n-áirítear páiste
altrama)
Cad é dáta breithe an duine seo?
Lá
A5
1
Mí
11
A4
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Duine nach gaol (lena n-áirítear páiste
altrama)
Cad é dáta breithe an duine seo?
Lá
A5
1
Mí
11
A4
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Duine nach gaol (lena n-áirítear páiste
altrama)
Cad é dáta breithe an duine seo?
Lá
A5
1
Mí
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
2
Pósta (lena n-áirítear Athphósta)
2
Pósta (lena n-áirítear Athphósta)
2
Pósta (lena n-áirítear Athphósta)
5
Idirscartha (lena n-áirítear Tréigthe)
5
Idirscartha (lena n-áirítear Tréigthe)
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
6
Colscartha
6
Colscartha
7
Baintreach
7
Baintreach
7
Baintreach
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
1
Níos lú ná 3 mhí
1
Níos lú ná 3 mhí
1
Níos lú ná 3 mhí
2
3 mhí nó níos mó
2
3 mhí nó níos mó
2
3 mhí nó níos mó
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
1
Bhí
1
Bhí
1
Bhí
2
Ní raibh
2
Ní raibh
2
Ní raibh
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
1
Is ea
1
Is ea
1
Is ea
2
Ní hea
2
Ní hea
2
Ní hea
Lch 22
FOIRM THEAGHLAIGH
Project1
30/06/2005
14:53
Page 4
Daoine as baile go sealadach ón teaghlach oíche Dé Domhnaigh 23 Aibreán
A1
A2
Duine as Láthair 4
Cad is ainm don duine?
Céad ainm agus sloinne
A1
A2
Gnéas
Duine as Láthair 5
Cad is ainm don duine?
Céad ainm agus sloinne
A1
A2
Gnéas
Duine as Láthair 6
Cad is ainm don duine?
Céad ainm agus sloinne
Gnéas
1
Fireann
1
Fireann
1
Fireann
2
Baineann
2
Baineann
2
Baineann
A3
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
A3
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
i mbosca amháin.
A3
i mbosca amháin.
i mbosca amháin.
1
Fear céile nó bean chéile
1
Fear céile nó bean chéile
1
2
Páirtí
2
Páirtí
2
3
Mac nó iníon
10
GAOL eile, sonraigh
11
A4
Cad é dáta breithe an duine seo?
A5
1
Mí
H
Fear céile nó bean chéile
Páirtí
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
Duine nach gaol (lena n-áirítear páiste
altrama)
Lá
Cén gaol atá ag an duine seo le
Duine 1 ar leathanach 4?
3
Mac nó iníon
3
10
GAOL eile, sonraigh
10
11
A4
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Duine nach gaol (lena n-áirítear páiste
altrama)
Cad é dáta breithe an duine seo?
Lá
A5
1
Mí
11
A4
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
Mac nó iníon
Duine nach gaol (lena n-áirítear páiste
altrama)
Cad é dáta breithe an duine seo?
Lá
A5
1
!
N
GAOL eile, sonraigh
Mí
Bliain
Cad é stádas pósta reatha an duine?
Freagair má tá an duine seo 15 bliana
d'aois nó níos sine.
i mbosca amháin.
Aonta (níor phós riamh)
2
Pósta (lena n-áirítear Athphósta)
2
Pósta (lena n-áirítear Athphósta)
2
Pósta (lena n-áirítear Athphósta)
5
Idirscartha (lena n-áirítear Tréigthe)
5
Idirscartha (lena n-áirítear Tréigthe)
5
Idirscartha (lena n-áirítear Tréigthe)
6
Colscartha
6
Colscartha
6
Colscartha
7
Baintreach
7
Baintreach
7
Baintreach
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
1
Níos lú ná 3 mhí
2
3 mhí nó níos mó
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
A6
Cá fhad san iomlán atá an tréimhse
atá an duine seo le bheith as baile?
1
Níos lú ná 3 mhí
1
Níos lú ná 3 mhí
2
3 mhí nó níos mó
2
3 mhí nó níos mó
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
A7
An raibh an duine seo i bPoblacht na
hÉireann Dé Domhnaigh, 23 Aibreán?
1
Bhí
1
Bhí
1
Bhí
2
Ní raibh
2
Ní raibh
2
Ní raibh
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
A8
An mac léinn/dalta an duine seo
atá as baile ag freastal ar scoil nó
ar choláiste?
1
Is ea
1
Is ea
1
Is ea
2
Ní hea
2
Ní hea
2
Ní hea
Má tá níos mó ná seisear as láthair go sealadach ón teaghlach
oíche Dé Domhnaigh 23 Aibreán, iarr comhairle ar d'Áiritheoir
le do thoil.
Lch 23
Sínigh an dearbhú ar an leathanach cúil, le do thoil.
FOIRM THEAGHLAIGH
Project1
30/06/2005
14:53
Page 1
Dearbhú le síniú ag Ceann an Teaghlaigh nuair atá an Fhoirm Dhaonáirimh comhlánaithe.
Sula síníonn tú an dearbhú seiceáil an méid seo a leanas le do thoil:
Go bhfuil na ceisteanna maidir le do chóiríocht ar leathanach 2 comhlánaithe agat.
Go bhfuil gach uile dhuine (lena n-áirítear cuairteoirí) a chaith oíche Dé Domhnaigh, 23 Aibreán, sa teaghlach áirithe agat
ar Liosta 1 ar leathanach 3 (má tá níos mó ná seisear i láthair, comhlánaigh an líon cuí Foirmeacha Pearsana Aonair).
Go bhfuil gach uile cheist ba chóir a fhreagairt le haghaidh gach duine a chaith oíche Dé Domhnaigh, 23 Aibreán, sa
teaghlach freagartha agat (leathanaigh 4-21).
Go bhfuil aon bhall den teaghlach a bhí as baile go sealadach oíche Dé Domhnaigh, 23 Aibreán, áirithe agat ar Liosta 2
ar leathanach 3 (má tá níos mó ná seisear as láthair, iarr comhairle ar d'Áiritheoir).
Go bhfuil na ceisteanna ar leathanaigh 22-23 a bhaineann le haon bhall den teaghlach a bhí as baile go sealadach oíche
Dé Domhnaigh, 23 Aibreán, freagartha.
H
Nach bhfuil aon duine curtha san áireamh faoi dhó ar an bhfoirm seo.
G I
I
A
Á
N
H
Á
M
L
H SA
M A
O L
C EO
Á
N AR
M
Dearbhú le comhlánú ag an duine atá freagrach as an bhfoirm a chomhlánú
Dearbhaím go bhfuil an fhoirm seo ceart agus iomlán a mhéad is eol dom agus a chreidim.
Síniú
!
N
Tá an fhoirm Dhaonáirimh comhlánaithe anois agat.
Go raibh maith agat as do chomhoibriú.
Sampla - Ceist 3 - Baill an teaghlaigh agus an Gaol atá acu lena chéile
I dteaghlach ina bhfuil suas le cúigear, ní mór do gach duine i ndiaidh Duine 1 sa teaghlach, an gaol atá acu
leis na daoine atá curtha san áireamh ar an liosta rompu a lua. I dteaghlaigh ina bhfuil seisear nó níos mó daoine,
ní mór do Dhaoine 5 agus níos airde an gaol atá acu le Daoine 1-4 amháin a lua.
Tá sé leagtha síos sa sampla seo conas ceist an ghaoil a chomhlánú don teaghlach ina bhfuil na daoine seo a
leanas: Eibhlín Uí Mhurchú, a fear céile Tomás, a n-iníon Caitríona agus a n-gariníon Aoife (iníon Chaitríona).
Ní bhaineann ceist an
ghaoil le Duine 1.
E IBHLIN UI MHURCHU
Ainm Duine 2
Ainm Duine 3
TOMAS O MURCHU
i mbosca amháin.
Gaol ag
DUINE 2 le
Duine
1
CAITRIONA NI MHURCHU
AOIFE NI MHURCHU
i mbosca amháin do gach duine.
i mbosca amháin do gach duine.
Daoine
1 2
Gaol ag
DUINE 3 le
Daoine
1 2 3
Gaol ag
DUINE 4 le
Fear céile nó bean chéile
1
Fear céile nó bean chéile 1
Fear céile nó bean chéile 1
Páirtí
2
Páirtí
2
Páirtí
2
Mac nó iníon
3
Mac nó iníon
3
Mac nó iníon
3
Leasleanbh
4
Leasleanbh
4
Leasleanbh
4
Deartháir nó deirfiúr
5
Deartháir nó deirfiúr
5
Deartháir nó deirfiúr
5
6
7
Máthair nó athair
6
Máthair nó athair
6
Máthair nó athair
Leasmháthair/leasathair
7
Leasmháthair/leasathair
7
Leasmháthair/leasathair
Cliamhain nó banchliamhain 8
Cliamhain nó banchliamhain 8
Cliamhain nó banchliamhain 8
Garleanbh
Garleanbh
Garleanbh
9
9
9
Gaol eile
10
Gaol eile
10
Gaol eile
10
Duine nach gaol
11
Duine nach gaol
11
Duine nach gaol
11
(lena n-áirítear páiste altrama)
Lch 24
Ainm Duine 4
(lena n-áirítear páiste altrama)
(lena n-áirítear páiste altrama)
FOIRM THEAGHLAIGH