62394
2010
POPULATION
AND HOUSING
CENSUS
Persons Questionnaire
1.
2.
3.
4.
Use No. 2 pencil only
Please make no stray marks on questionnaire
Please do not write answers in the boxes
Please circle or tick answers where appropiate
Island ________________________________________
Enumerational District __________________________
Electoral District _______________________________
Building/Housing Unit Number _____________________
Dwelling Unit Number _____________________________
Household Number _______________________________
Address of Household _____________________________
Persons Number _________________________________
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STRICTLY CONFIDENTIAL WHEN COMPLETED
CENSUS DAY - JUNE 12th, 2010
Instructions:
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SECTION 6: PERSONAL CHARACTERISTICS
Name
40: What is your / (N)'s full name?
______________________________________
Relationship to Head
41. What is your / (N)'s relationship to the
head of the household?
1. Head
2. Spouse of Head
3. Partner of Head
4. Child of Head and Spouse/Partner
5. Child of Head only
6. Child of Spouse/Partner only
7. Spouse/Partner of Child of Head
8. Grandchild of Head/Spouse/Partner
9. Parents of Head/Spouse/Partner
10. Other Realtive of Head/Spouse/Partner
11. Domestic Employee
12 Other Non-relative
13 Not Stated
Sex
42: What is your / (N)'s sex?
1. Male
2. Female
Date of Birth
43: What is your / (N)'s date of birth?
Day
Month
Year
Age
44: What was your/ (N)'s age at his/her last
birthday?
Age ___________
(ALL AGES)
Ethnic Group (All Ages)
45: To which ethnic group do you/(N) belong?
1 African/Black
2 Creole
3 Carib
4 Amerindian
5 White/Caucasian
6 Chinese
7 Indian
8 Philippinos
9 Asian (other)
10 East Indian
11 Hispanic/Latinos
12 Mixed
13 Syrian
14 Lebanese
15 Other middle east
16 Other Ethnic Groups,
specify____________________
17 Not Stated
Religion/Faith (All Ages)
46: What is your/ (N)'s affiliation with a
religion or faith?
1 Anglican
2 Church of God
3 Evangelical
4 Methodist
5 Moravian
6 New Testament Church of God
7 Pentecostal
8 Presbyterian
9 Roman Catholic
10 Seventh Day Adventist
11 Jehovah's Witness
12 Baptist
13 Baha'i
14 Hindu
15 Judaism
16 Mormon
17 Muslim/Islam
18 Rastafarian
19 Budhaism
20 Other affiliation, specify
___________________________
21 None/No Religion
22 Not Stated
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SECTION 7: MARITAL AND UNION STATUS
(FOR PERSONS 15 YEARS AND OVER)
Marital Status
47: What is your / (N)'s marital status?
1 Single/Never Married
2 Married
3 Divorced
4 Widowed
5 Legally Separated
6 Not stated
7 Don't know
Union Status (for both Males & Females)
48:What is your/ (N)'s present union status
1 Never had a spouse or common-law partner
(Go to Q50)
2 Married and living with spouse
3 Married but not living with spouse.
4 Common Law/de facto marriage
5 Visiting partner
6 Not in Union (Go to Q50)
7 Don't Know (Go to Q50)
8 Not Stated (Go to Q50)
Age at first Marriage or in a Union
49: How old were you/ (N) when first married
or in a union for the first time?
Age _________
SECTION 8: MARITAL AND UNION STATUS
(FOR PERSONS 15 YEARS AND OVER)
54: Why did you come to live in this country?
1 Employment
2 Moved with spouse
3 Moved with family
4 Education Opportunities
5 Retired
6 Other
7 Don't know
8 Not stated
Place of Birth
50: Where were you/(N) born?
1 In this country
2 Abroad (Go to Q52)
3 Don't Know (Go to Q53)
51: What was the name of the community
where your/ (N)'s mother usually lived?
Village/Community,
________________(Go to Q55)
Duration of Residence
55: In what year did you/ (N) come to live in
this community/village?
Office Use
52: In which country were you/ (N) born?
Country
___________________________
Year ___________
If 2009 or earlier, (Go to Q57)
Office Use
Location of Last Residence
56: In what village/community did you/ (N) last
live?
53: In what year did you/ (N) come to live in
this country?
Year ____________
Village/Community
_______________________
Office Use
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Place of Usual Residence
57: Where do you/(N) usually live?
1 This address
2 Another address in this country
3 Abroad
4 Not stated
Residence at Last Census
60: Where did you/(N) live when the last
census was conducted in 2001?
1 At this address (Go to Q64)
2 Another village/community in this country,
specify (Go to Q64)
__________________________
Office Use
3 Abroad
4 Don't know (Go to Q64)
5 Not stated (Go to Q64)
Address of Usual Residence
58: What is the village/community name of
your/ (N)'s usual residence?
Village/Community
________________________
Country of Residence at Last Census
61: In which country did you/(N) last live?
Office Use
Residence Five Years Ago
59: Where did you/(N) live five years ago?
1 This address (Go to Q60)
2 Another village/community in this country
(Go to Q59a)
3 Abroad (Go to Q59b)
4 Don't know (Go to Q60)
5 Not stated (Go to Q60)
Country
_______________________
Year of Return
62: In what year did you/(N) return to this
country?
Year _____________
59a: Village/Community
Reason for Return
63: What was the main reason you/(N)
returned to live in this country?
1 Regard it as home
2 Family is here
3 Deported/Involuntary return
4 To start a business
5 Retired
6 Homesick
7 Employment
8 Got Married
9 Other, specify _______________
_____________________
Office Use
59b: Country
________________________
Office Use
Office Use
SECTION 9: CITIZENSHIP
Children born in the past 12 months who have 116: Of what sex and age, in months, were the
died
children who died in the past 12 months?
115: How many of the children who were born
to you/(N) in the past 12 months have died?
Child No.
Sex
Age (Months)
Total Number ________
SECTION 17: CENSUS NIGHT
(ALL AGES)
Location on Census Night
117: Where did you/(N) spend census night?
1 This household
2 Elsewhere in the country
3 In an Institution (eg. Hospital, prison, military
camp, hotel)
4 Abroad
5 Other
6 Not Stated
118: Were there any births/deaths or additions
during census night?
1 Yes
2 No
(END, GO TO THE NEXT PERSON - IF APPROPIATE)
(ALL AGES)
Citizenship
64: Of which countries are you/(N) a citizen?
Country____________________
Country____________________
Country____________________
Office Use
65: Legal Status
What is your legal status in this country?
1 Born in this Country (Go to Q69)
2 Non-belonger (Go to Q68)
3 Belonger
4 Resident
5 Naturalized
6 Other
7 Don't know
8 Not stated
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For what reason did you use the internet?
(Choose all that apply) cont'd
1 Yes
2 No
i
Software (downloading)
j
Online dating
o Playing games
67: How did you obtain this legal status?
1 Marriage
2 Longevity
3 Honorary
4 Became eligible
5 Other, specify ______________
6 Not stated
q Email
r
Surfing (general)
s Other, specify
Gambling
m Booking flight reservations
SECTION 10: DISABILITY
n Reading online news
SECTION 16: FERTILITY
(ALL FEMALES 12 YEARS AND OVER)
Children ever born (live born)
Age (last born)
109: How many live born children have you/(N) 112: How old were you/(N) when you/she had
ever had and how many were male and how
her last live born child?
many were female?
Age _________
Total Number
Males
Females
Date of birth of the last child born alive
113: What was the date of birth of the last
child born alive to you/(N) ?
Day
Live Born still alive
110:How many of your/(N)'s live born children
are still alive?
Total Number
Males
68: Have you applied for a change in your
legal status?
1 Yes
2 No
Year _____________
p Farming
k Adult entertainment
l
66: What year did you achieve this legal
status?
Month
Year
Females
Live births in the past 12 months
114: How many live births did you/(N) have in
the past 12 months?
One birth (with one baby)
Age (first born)
Two separate births
111: How old were you/(N) when you/she had Twins
her first live born child?
Three or more
None
Age _________
Not stated
(ALL AGES)
Disability Status (respond only where the
disability has been continuous for 6 months
or more)
69: Indicate the level of difficulty you have
with the following disabilities.
1-No difficulty
2-Some difficulty
3-Yes, lots of difficulty
4-Cannot do (it) at all
70: What is the origin of your/(N)'s disability?
1-From Birth
5-Developed over time
2-Illness
6-Other, specify
3-Accident
7-Don't know
4-Inflicted
a . Seeing (even with glasses)?
c Walking or climbing stairs?
b. Hearing?
d Remembering or concentrating?
c. Walking or climbing stairs?
e Behavioral (mental retardation)
d. Remembering or concentrating?
f Learning or understanding
e. Self Care?
g Communicating and speaking?
f. Upper body functions?
h Upper body functions?
g. Communicating and speaking?
i Self Care?
h. Behavioral (mental retardation)
j Upper body functions?
i. Learning or understanding
k Communicating and speaking?
a Seeing (even with glasses)?
b Hearing?
l Behavioral (mental retardation)
if code 1-no difficulty is the response for all
disabilities. Go to Q72
m Learning or understanding
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71: Are you / (N) required to use any of the
following aids? (Indicate all that apply)
1 Yes
2 No
3 Don't know
Other sources of Livelihood (All Ages)
105: In what income range are the amounts of
Friends/family (Local)
your /(N)'s other sources of livelihood?
(Indicate as many sources as apply) (Show
Friends/family (abroad)
Flash Card for Amount))
1 Yes
Amount
Spouse/Partner
2 No
d Crutches
e Orthopedic Shoes
f Braille
a Wheelchair
g Other, specify
b Cane
h Adapted Car
c Prosthesis/artificial body part
SECTION 11: HEALTH
(ALL AGES)
72: Do you/(N) suffer from any of the following Do you/(N) suffer from any of the following
illnesses? (Indicate all illnesses that apply)
illnesses? cont'd
1 Yes
2 No
l HIV/Aids
3 Don't know
m Carpal Tunnel Syndrome
a Arthritis
n Respitory disease
b Kidney disease
o Other, specify
c Asthma
____________________
g Anemia
h Glaucoma
j Heart disease
k Lupus
Parent(s)
Investments
Guardian(s)
Remittances
Alimony
Savings
Backyard Farming
Disability benefits
Other, specify
Jobless benefits
Notes: Mark all sources even though they may be minor in
terms of the total amount of the source of livelihood
SECTION 15: INTERNET ACCESS
74: Which of the following insurance
programs do you/(N) have?
1 Social Security
2 Life with Health
3 Group Health
4 Individual Health
5 Endowment with Health
6 Don't Know
7 Other, specify
i Cancer
Pension (overseas)
Other public help
73: Are you/(N) covered by insurance (health,
life, national, etc.)?
1 Yes
2 No
3 Don't Know
4 Not Stated
f Sickle cell
Children
Social security benefits
d Diabetes
e Hypertension
Pension (local)
(ALL AGES)
106: Access to the Internet
Have you/(N)/accessed to the internet within
the past 3 months?
1 Yes
2 No
Current Use
107: How did you/(N) mainly access the
internet in the past 3 months?
1 Home (fixed line)
2 Work (fixed line)
3 School (fixed line)
4 Internet Café (fixed line)
5 Public Library
6 Cellular Phone (Blackberry is a cellular phone)
7 Personal Digital Assistant (PDA)
8 Family or Friend's House (fixed line)
9 Areas with Public access point
10 Other, specify ______________
11 Don't Know
108: For what reason did you use the internet?
(Choose all that apply)
1 Yes
2 No
a Research
b Shopping
c Chatting (messenger)
d Internet phone (skype etc.)
e Movies (watching)
f
Music (listening)
g Movies (downloading)
h Music (downloading)
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Usual Activity Status
96:What did you/(N) do most during the past
12 months?
1 Had a job and worked
2 Had a job, but did not work
3 Seeking first job (Go To Q101)
4 Seeking a job which was not the first (Go To
Q101)
5 Did not seek but wanted work and was
available (Go To Q101)
6 Attended school/Student (Go To Q101)
7 Did Home Duties (Go To Q101)
8 Retired, did not work
9 Disabled, unable to work
10 Others, specify _____________
11 Not stated
100: What percent is this income of your total
income
% of Total Income _______
(Go to Q102)
Steps Taken to Look for Work
101: What steps did you/(N) take during the
past week to look for work?
1 Direct application (sent out letters, completed
application form)
2 Checking at work sites etc.
3 Seeking assistance from friends
4 Registered at public employment recruitment
agency
5 Registered at private employment recruitment
Months Worked
agency
97: How many months did you/(N) work during 6 Await pick-up for day work
the past 12 months?
7 Others, specify_____________
8 Not stated
Number of Months __________
102: Do you sell goods or provide a service
(if Don't Know, use code 98)
but have no stationery location?
(if Not Stated, use code 99)
1 Yes
2 No (Go To 105)
Income
98: How often do you/(N) get paid from your / 103: Do you have a trade license for this
their main job?
business?
1 Weekly
1 Yes
2 Fortnightly
2 No
3 Monthly
4 Quarterly
104: In what income range does your monthly
5 Annually
earnings fall? (Show Flash Card)
6 Other
7 Not applicable (Go To Q106)
8 Don't know (Go To Q106)
Income Range _________
Gross Income last pay period
99: In what income range was your/(N)'s
pay/income during the last pay period from
your main job? (Show Flash Card)
Income Range ___________
SECTION 12: EDUCATION
(ALL AGES)
What is the highest level of education that
you/(N) have attained? cont'd
Current School Attendance
75: Are you/(N) currently attending an
Education Institution?
1 Yes
2 No (Go To Q77)
13 College/Tertiary/University 1-2
14 University/Tertiary (Bachelor's)
15 University/Tertiary (Master's)
16 University/Tertiary (PhD)
17 Special School/Education
18 Other, specify______________
19 Don't Know
76: What type of Educational Institution are
you/(N) attending?
1 Day care/nursery
2 Pre-school
3 Pre-primary School
4 Government Primary School
5 Private Primary School
6 Special Education
7 High School
8 Vocational/Trade
9 Business/ Computer Science
10 Commercial/Secretarial
11 Adult/Continue Classes
12 Distance Learning, specify
__________________
13 Correspondence/Internet
14 College/Tertiary 1-2
15 University/Tertiary
16 Other, specify _____________
17 Not Stated
Highest Examination passed/Qualification
obtained
78: What is the highest examination you/(N)
have ever passed?
1 Primary School Certificate
2 Cambridge School Certificate
3 CXC Basic
4 GCE O' levels or CXC General
5 High School Cert (HSC)
6 GCE A' levels CAPE
7 College Certificate/Diploma
8 Associate Degree
9 Bachelor's degree
10 Post graduate Diploma/Certificate
11 Professional Certificate
12 Higher Degree (Masters)
13 Higher Degree Doctoral)
Educational Attainment
77: What is the highest level of education that 14 Other, specify ______________
15 None
you/(N) have attained?
16 Not Stated
1 No Schooling/Pre-school/Daycare/Nursery
2 Pre-primary education
3 Primary (grades 1-2)
4 Primary (grades 3-5)
5 Elementary
5 Junior Secondary
6 High School (1-3)
7 High School 4 +
8 Sixth Form (A' level)
9 Post Secondary Technical
10 Vocational/Trade
11 Business/ Computer Science
12 Commercial/Secretarial
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SECTION 13: PROFESSIONAL , TECHINCAL AND VOCATIONAL TRAINING (15 YEARS PLUS)
SECTION 14: ECONOMIC ACTIVITY
79: Have you/(N) ever received or attempted
any training or are you/(N) currently being
trained to fit for employment, occupation or
profession?
1 Yes
2 No (Go to Q86)
Current Activity Status
86: What did you/(N) do mostly during the
past week?
1 Had a job and worked
2 Had a job, but did not work
3 Seeking first job (Go To Q101)
4 Seeking a job which was not the first (Go To
Q101)
5 Did not seek but wanted work and was
available (Go To Q105)
6 Attended school/Student (Go To Q105)
7 Did Home Duties (Go To Q105)
8 Retired, did not work (Go To Q105)
9 Disabled, unable to work (Go To Q105)
10 Other, specify
________________(Go To Q105)
11 Not stated (Go To Q105)
89: Do you have secondary and tertiary jobs?
1 Yes
2 No (Go To Q92)
Employment Status (Current)
87: What type of worker status applies to
you/(N) ?
1 Paid employee, State owned/Government
2 Paid employee, Statutory Board
3 Paid employee, Private Establishment
4 Paid employee, Private Home
5 Own business/ Self-employed with paid
employees
6 Own business/ Self-employed without
Employees
7 Apprentice/Learners
8 Unpaid Worker/Employee
9 Volunteer worker
10 Contributing family member/worker
11 Other, specify _____________
12 Don't know
13 Not stated
Main Industry and type of business
92: What main business is carried out at
your/(N)'s work place?
Period of Training
83: How long was the period of your/(N)'s
highest level of training (in months)?
Months ____________
Training Status
80: Which category of training status applies
to you/(N) ?
1 Completed training
2 Undergoing training currently
3 Attempted training but did not complete
4 Don't Know
5 Not Stated
Type of Certification
84: What type of qualification or certification
did you/(N) receive on completion of the
training at the highest level?
1 None
2 Certificate with examination
3 Certificate without examination
4 Diploma
5 Advanced Diploma
6 Associate Degree
Field of Training
7 Bachelor's Degree
81: What is the field for which the highest
level of training was completed, attempted or 8 Post Grad. Degree
9 Professional Qualification
is undergoing by you/(N) ?
10 Other, specify ______________
11 Don't Know
Field ________________
12 Not Stated
82: What was the main method used by
Training relationship to Job
you/(N) to train in this field?
85: Is your/ (N)'s training related to your/(N) 's
1 On the job
present job?
2 Private Study
1 Yes
3 Apprenticeship
2 No
4 Correspondence course
5 Secondary School
6 Vocational/Trade school/Technical Institution
7 Commercial/Secretarial School
8 Business/Computer School
9 University (on campus)
10 Institute
11 Distance Learning
12 Online/Virtual learning
13 Other, specify ______________
14 Don't Know
15 Not Stated
(15 YEARS AND OVER)
90: How many other jobs do you have?
Number of Jobs __________
91: What are these jobs?
job#2 ____________________
job#3 ____________________
job#4 ____________________
Office Use
Industry _______________
93:How many hours did you/(N) work during
the past week?
Hours worked _______
Place of Work
94:Where is your/(N)'s place of work?
1 Fixed place of work outside the home
2 Work at home (Go To Q96)
3 No fixed place of work (Go To Q96)
4 Don't know (Go To Q96)
5 Not Stated (Go To Q96)
Main Occupation
88: What kind of main work were you/(N)
doing during the past week?
Work/Office Address
95:What is the name and address of your/(N)'s
workplace?
Name _____________________________
Address ___________________________
__________________________
Occupation ______________________
Office Use
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