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INSTRUCTIONS
Use No. 2 pencil only. (Do not use ink or ballpoint pen.)
Completely fill in the oval response.
Enuu, cleanly any changes you make.
Make no stray marks on this form.
Incorrect Marks
Q D W O Q
Of Household
Correct Mark
AREA
NUMBER
NUMBER
I
NUMBER
"OUSEHOLD
I
TIME STARTED
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RESULT*
'Result Codes:
1 = Completed
Address not f
No suitable re
2 = Partially completed, call back
3 = Dwelling vacant
4 = Address not a dwelling
SUPERVISOR
L
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-
EDITOR
NAME
A
. ..
,
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r..
9
COMMENTS
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1 0 Yes
2 0 No
%7
(SKIP TO Q 1.2&&
p-
b) How many pemms?
1
0
2 0
3
0
FEMALE
MALE
1.1 (ml 4!u anybody from thim hour;
4 0
6
1.
1
0
2 0
2.
1
0
2 0
3.
1
0
2 0
(0
0
Piease give me the sex and ag.of each.
C)
questions about the dwelling which your household occupies and
only if the a n s w e r is
1.5 What is the construction material of the outer walls?
0 Btlck
60Adobe
7 0 Makesh~ft
8 Q Other/Don't know
6
2
3
1
1.2 W L typ
~ ot h o t l i n g don hihmwhobd ourpv?
1 0 Undtvided private house
1.6 What is the material wed for roofing?
1 0 Sheet metal (zinc, aluminum, galvanize).
2 0 Shingle (asphalt)
3 0 Shingle (wood)
4 0 Shingle (other)
6 0 Tile
6 0Concrete
7 0 Makeshift
8 0 Other/Don't know
2 0 Part of a private house
3 0 Flat/apartment/condominium
10 Townhouse
5 0 Double hwse/duplex
I0Combined business 8. dwelling
7 0 Barracks
:omher
1.3 m
0 Concrete
0 Wood 8 Concrete
1
s this household own, rent or base this dwelling?
1 0 Owned
2 0 Squatted
1.7 In which year was this dwelling built?
4 0 1980 or later
l 0 Before 1960
6 0Don't know
2 01960 - 1969
3 0 1970 1979
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3 0 Rented-hivat
1.8 What ia the main source of your water supply?
(SKIP TO Q. 1.5)
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about thebnd-isltfmohdd, leasehdd. or
other rnaf =clRam?
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1 0 Rivate, piped into dwelling
2 0Private catchment, not piped
3 0Public, piped into dwelling
~
5
6
7
p
r
~
v
0 Public standpipe
0 Public well or tank
0 Other
a
r
d
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1.9 What type of toikt facilities does this housshdd have?
1 0 W.C. linked to
Rented
~ermiiont0worfc~W
Sharecropping
Squatted
0th
Don't know/Nat
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sewer
z 0 W.C.Cesspit or septic tank
3 0Pit-Latrine
4 0 Other
1.10 Am thew toilet facilities shared with another person
not of this household or another household?
1.16 How many bedrooms are there ir
m
this dwelling unit? Bedrooms a
moms used mainly for sleeping a
exclude makeshift and temporary
sleeping quarters. Cwnt all
bedrooms including spares not
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10 Yes
20No
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1.1 1 What type of lighting does this househdd use most?
10 Gas
20Kerosene
3 0 Electricity
400th~
\-
1.12 What type of fuel does thii househdd use most for
cooking?
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1.17 Now Iwoukl like some information on the ownership
or rental of wch facilities as television sets, videos
and radios by members of the household.
1 0 Coal
20Wood
0 Gas
40Kerosene
6 0 Electricity
3
(a) How many radios are owned or rented by
members of this household?
I0 Other
1.13 Is your k
i
n indoom or outdoors?
(b) How many television sets are owned or rented
by members of this houqehold?
10lndoors
20outdoors
1.14 la the k i h e n shared with another person not of this
household or another household?
(c) How many video recorders are owned or
by members of this househokl?
10 Yes, shared
2 0 Not shared
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1.15 How many rooms does your household occupy? Do
not count bathrooms, porches, kitchens, etc.
COMMENTS
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PERSON 1- .
FOR ALL PERSONS I
SECTION 4. BIRTHPLACE AND RESIDENCE
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4.6 kr what bown,
vW*p.ordimktin
d#
b / s h M Ih?
......
0 Don't know
0 Nwer moved
...conw
4.7 In what y u r did..
vi#.geor d h k t ?
0 Don't
L
19
l
(SKIP TO Q 6.1)
live in thb town,
- l 1 PmQPa-memmml
rmrnrnrnmmmrr..~.m
3 ALL
IN AND TRi
... ..
6.1 b
. mending ay rchool or educational
institah now, wh.th.r full-tima or part-time?
1 0Yes
2ONo
3 0 Don't know
(SKIP TO 0.6.6)
(SKIP TO Q 6.6)
5.2 Am you/u/ho/.h. .tbmding fvll-time or part-tinn?
1 0 Full-time
3 0 Don't know
2 0 Part-time
5.3 What type of school or inrtihttionam you/b/he/h
attending?
1 0 Nu~y/lnfant/Kindergam/Re-school
2 0 Primary
3 0 Sen& Schod or Secondary Dept. of R i m y School
~40JuniorSecondary
r 0 senior Secondary, General Secondary, H i School
~ e o r C ~ s c h o o l
I0 Trade/Vocational School
7 0%chnical Institute
8 0 Community Cdkgs/Sixth Form College
8 0Univmity
10 0Other ~PIeawspeafy)
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11 0Not stated
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FOR PERSONS 15 YEARS & OVER
rn
6.5 Wh.tkya#/his/hwmainmod.oftrardbotha
ochool or inrtitution?
1 0 w& w:'
: '
20BicVde
3ORivebecarorvbhide
4 0 wi vdricle (bus. atc.)
I0 Hired t r a m (taxi, maxi-taxi, minibus)
I0 Don't know/Not smmd
70Other
,'
tL
6.6 W h a t i r t h ~ h i d w s t k n l o f ~ t .......
ha
hu'mdnd?
1ONone
(SKIP TO Q 6.9)
2 0 Nursery/Kindergar$qn (SKIP TO Q 6.9)
3 0 Primary
I
4 0 secondary
6 0 Re-University/Post-Secondary
(SKIP TO Q 6.8)
I0 University
7 0 Other (Please specify) (SKIP TO Q 6.9)
I-.
FOR OFFICE
USE ONLY
'
80Natstetad
(SKIP TO Q 6.9)
1
& ~ F E R T I C I T Y ~FOR
~ - -PERSONS
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15 YEARS &
~ECTION6. MARITAL STATUS, UNION =US
-
.. .
is. . .'a &pJ marital status that is, are
/is he/she married, divorced, kgrlly wp.ntrd,
owed or never marrid?
m-.
3t
3 Married
3 Divorced
3 Legally separated
4
2 Never married
3 Not stated
%2
,
g
t
.. . .
6.8 How many livebirths has..
ever had?
(IF ZERO, ENTER 00 & SKIP TO 0.7.1)
r
.
A
I
P,.
1
3 Widowed
$-
(SKIP TO Q. 6.3)
you/is he/she living wRh your/his/her
aand/wife now?
1
0 Yes
(SKIP TO Q. 6.6:
OVER
2
6.9 How old were you/was she when you/she had the
first liveborn child?
-
0 No
9.3 Are you/is he/she living with a partner now?
1 0 Yes
:
,
(SKIP TO Q. 6.6)
2 0 No
6.10 How old were you/was she at the birth of your/her
last liveborn child?
-
%
. -$A
INTERVIEWER: If 4.6.3 is shaded 2 (No) and Q. 6.1
is shaded 2.3 or 4 then Skip to 4.6.6.
- . 28.5 Have you/has he/rhe ever lhnd togethar with a
; partner in a common law relationship?
1 0 Yes
2 0 No
(SKIP TO Q. 6.7)
6.1 1 How many livebirths did you/she have in the last 12
months?
3.6 How old were you/he/she when you/he/she were/was
first married or lived with a partner?
:
,
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4 0 Twins
-6 Q
. Three or more
3:.
.
6.12 What ir/are the rex(es) of this child/these children?
!?
.
1 0 None (SKIP TO 0.7.1)
2 0 One
3 0 Two separate births
Number of Boys @
NumberofGirls @
36.7 INTERVIEWER: Mark the appropriate oval.
(See Qs. 2.3.2.4.6.1.6.2.5.3)
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w n ~ rI V
" 3 Female under 65 years attending school
3 Female under 65 years not attending school
1 0 Yes
Q.7.1)
6.1"
many have died?
0
CC)
CC)
0
Q)
.... do most durina the past 12
lths for example, did you/he/she work, look for
,,A, keep house or carry on some other activity?
1 0 Worked
(SKIP TO Q. 7.4)
2 0 Had a job but did not work (SKIP TO Q. 7.4)
3 0 Looked for work
4 0 Wanted work and available
6 0 Home duties
8 0 Attended school
7 0 Retired
8 0 Disabled, unable to work
9 0 Other (Please wecify)
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. .2 0 No
0
0
(SKIP TO Q 7.1)
0
QD
CB
FOR PERSONS 15 YEARS & OVI
ECONOMIC ACTIVITY
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@
CD
6.13 Of these, have any of the babies died?
1 0 Male
2 0 Female 65 years & over
a t did..
B>
CD
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. .. .
7.6 What did..
do most durina the m s t week
for example, did you/he/she work, look for a job,
keep house or carry on some other activity?
1 0 Worked
(SKIP f0 Q. 7.8)
(SKIP TO Q. 7.8)
2 0 Had a job but did not work
3 0 Looked for work
4 0 Wanted work and available <- 6 0 Home duties
8 0 Attended school
7 0 Retired
--) (SKIP TO Q. 7.7)
8 O Disabled, unable to work
8 C ) Other (Please specify)
a
2
-
1
10 CJ Not stated
10 C:, Not stated
7.2 Did you/he/she do any work at all in the past 12
months? Include work at home, for example, piece
work, unooking, etc.
1 0 Yes (SKIP TO 0.7.4)
"+;.z=:,- q
7.9
7.6 What sort of work
did you/he/she
look for or want?.
I
I
(SKIP TO 0. 7.7)
F.. = - . ,
2 0 No
3 0 Don't know
Have you/he/she MI.worked or had a job?
' OYes>
i
ONO
(SKIP TO Q. 7.5)
E.-
7.4 How many months did you/he/shq work in the past
&2
12 months?
fiS5
Number of months
QDcDmCS)aQ)Q)mQ>aDmmdD
7.7 Did you/he/she do any work at all last week for any
length of time, including helping in a family
business/farm, street vending or work at homd
1 0 Yes
2 0 No
(SKIP TO Q 7 9 )
7.8 How many hours did you/he/sha work last Hmk?
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PERSON 1
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7.9 What sort of work did you/he/she, do you, does
7.14 Did you/he/sha carry on your/hii/her own burineu,
work for a wage or salary or as an unpaid workor in
a family business?
I
0Paid empbyee - Government
(SKIP TO Q. 7.18)
s he/she move all your/his/her &;ii
'
e.g., fruits, nuts, lottery tickets,
7.10 Would you consider this job to betompletely
dependent, partially dependent or not dependent
on tourism?
1
0 Completely dependent
2 0 Partially dependent
3 Q Not dependent at all
4 0Don't know/Not stated
ype of business is/was carried on at
7.12 What is the name and address of your/his/her
present
workplace?
6
0Other (Please specify)
8
0 Not stated
7.17 What was.. . . . .'s gross pay/income during t
pay period, that is before income tax or other
deductions? (PRESENT FLASH CARD)
"
h q
."a
&&
INTERVIEW: For self-employed persons obtain
income," i.e., receipts less business expenses.
.
0Don't know
0No present workplace (SKIP TO Q. 7.18)
7.18 Do you/does he/she receive any money from fa&...
7.13 How do you/does he/she travel to work?
I
2
3
4
5
6
0 Work at home
0 Walk
0 Bicycle
0Private car or vehicle
1 0 Yes
2 0No
.
(SKIP TO 0.8.1)
monev did vou/he/she
receive last year (1990) from family and/or friends
broad? (PRESENT FLASH CARD)
0 Public vehicle (bus, etc.)
0Hired transport (taxi, minibus, maxi taxi, etc.)
7 0 Other
8 0 Don't know/Not stated
IMPORTANT
INTERVIEWER: If interview conducted before census day, ask o n return visit immediately after census*
If interview conducted after Census day, ask as part o f t h e full interview:
here did . . . . . . spend Census night?
0 At thls address
(END INTERVIEW)
2 0 Elsewhere in this country
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8.2 What part of the c d n t r y was that7 If known, please specify.
INTERVIEWER: W r h
$