For office use:
Locality: ____
Household number: ____
Village/locality/settlement: ____
Household number: ____
For all persons
[Questions 1-13 were asked of all persons]
____
2. Relationship
____
3. Sex
_
4. Date of birth
Day____
Month_____
Year____
5. Ethnic group
____
6. Marital status
____
7. Real father
____
8. Real mother
____ / __
9. Religion
____
10. Place of birth
____
Town if urban area, village or settlement if rural.
____
11. Where living in 1981
____
Town if urban area, village or settlement if rural.
____
12. School attendance
____
13. Educational attainment
____
For all persons born in 1971 or before
[Questions 14-17 were asked of all persons born in 1971 or before]
14. Type of activity last week
____
If no work, what was the reason? Looking for work, not looking, housewife, student, pensioner, too old, disabled, etc.
____
15. Occupation
What kind of work does the person do?
____
16. Industry
If self-employed, what is the person's trade or business?
____
17. Employment status
____
For all women born in 1971 or before
[Questions 18-22 were asked of all women born in 1971 or before]
18. How many of the children that this woman has borne alive were here on Census night?
Boys: _
Girls: _
19. How many were elsewhere?
Boys: _
Girls: _
20. How many have died?
Boys: _
Girls: _
21. When was the last child born?
Month____
Year____
22. Is the child still alive?
____
[Household section of the questionnaire]
Tick appropriate left-hand box.
1. Type of living quarters
[] 2 A building that houses two or more households
[] 3 A hotel or lodging house
[] 4 Other, specify
2. Construction of outer walls
[] 2 Wooden walls
[] 3 Permanent walls of tin or corrugated iron
[] 4 Walls of traditional bure [wood and straw hut] materials
[] 5 Walls of makeshift or improvised materials
[] 6 Walls of other materials, specify
3. Number of rooms
_ _
4. Water supply
[] 2 From a communal standpipe
[] 3 Rooftank
[] 4 Borehole
[] 5 Well
[] 6 River or creek
[] 7 Other, specify
[] 2 Sometimes
[] 3 Every year
[] 2 No
[] 2 FSC
[] 3 Vatukoula
[] 4 Village power plant
[] 5 PWD
[] 6 Own plant
[] 7 Other, specify
6. Lighting
[] 2 Kerosene lamp
[] 3 Benzine lamp
[] 4 Solar power unit
[] 5 Other, specify
7. Cooking fuel
[] 2 Kerosene
[] 3 LPG [liquefied petroleum gas]
[] 4 Electricity
[] 5 Other, specify
8. Toilet facilities
[] 2 Water sealed privy for exclusive use
[] 3 Toilet or privy shared with others
[] 4 Pit latrine
[] 5 Other, specify
[] 6 None
9. Tenure
[] 2 Rent them from a private landlord
[] 3 Rent them from the Housing Authority
[] 4 Occupy government or institutional housing
[] 5 Occupy housing by leave of the employer
[] 6 Squatter
[] 7 Occupy living quarters in some other way, specify