Fifth Census of Canada
Population by name, personal description, etc.
Enumeration District No.
City, town, village, township or parish
Numbered in the order of visitation
1. Dwelling House _ _
2. Family, household or institution _ _
Residence and personal description
3. Name of each person in the family, household or institution
4. Place of habitation (Township or parish, city, town or village. Range or concession and lot of cadastral number if in township or parish. Street and house number if in a city, town or village. Or other description.)
6. Relationship to head of family or household
7. Single, married, widowed, divorced or legally separated
Citizenship, nationality and religion
11. Country or place of birth (If in Canada specify province or territory)
12. Year of immigration to Canada. If an immigrant.
13. Year of naturalization. If formerly an alien.
Profession, occupation, trade or means of living
18. Employment other than at chief occupation or trade, if any
21. Working on own account. (See instructions)
22. State where person is employed, as 'on farm', 'in woolen mill', 'at foundry shop', 'in drug store', etc.
23. Weeks employed in 1910 at chief occupation or trade
24. Weeks employed in 1910 at other than chief occupation or trade, if any.
25. Hours of working time per week at chief occupation
26. Hours of working time per week at other occupation, if any
27. Total earnings in 1910 from chief occupation or trade
28. Total earnings in 1910 from other than chief occupation or trade, if any
29. Rate of earnings per hour when employed by the hour ? cents
31. Against accident or sickness $
32. Cost of insurance in census year $
Education and language of each person five years of age and over
37. Cost of education in 1910 for persons over 16 years of age at College, Convent or University $
Infirmities (Specify age when infirmity appeared)