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Commonwealth Caribbean Population Census

1. Identifying Number:

Country: 5
Parish: _ _
Constituency: _ _
Town/Spec. Area: _ _
ED Number: _ _ _
Housing Unit Number: _ _ _

2. Name of Individual: ______
Section 1: Identity[All persons]
3. Housing unit number: _ _ _
4. Dwelling number: _ _
5. Household number: _
6. Individual number within household: _ _

Section 2: Characteristics[All persons]
7. Relationship to the head of household:

[] Head
[] Spouse/partner
[] Child of head/spouse
[] Spouse of child
[] Grandchild
[] Parent of head/spouse
[] Other relation
[] Domestic employee
[] Other, not related
[] Not stated

8. Sex:

[] Male
[] Female

9. Age, in completed years: _ _
10. Marital status:

[] Never married
[] Married
[] Widowed
[] Divorced
[] Legally separated
[] Not stated

11. Usual residence

a) Local or foreign:
[] This household
[] Elsewhere in country
[] Abroad
[] Not stated
b) Parish in Jamaica:

[] Saint Elizabeth
[] Manchester
[] Clarendon
[] Saint Catherine
[] Kingston
[] Saint Andrew
[] Saint Thomas
[] Portland
[] Saint Mary
[] Saint Ann
[] Trelawney
[] Saint James
[] Hanover
[] Westmoreland
[] Not stated

12. Birthplace

a. Parish in Jamaica:
[] Saint Elizabeth
[] Manchester
[] Clarendon
[] Saint Catherine
[] Kingston
[] Saint Andrew
[] Saint Thomas
[] Portland
[] Saint Mary
[] Saint Ann
[] Trelawney
[] Saint James
[] Hanover
[] Westmoreland
[] Not stated
b. Foreign country:
[] Trinidad and Tobago
[] Guyana
[] Barbados
[] Belize
[] Other Commonwealth in the Caribbean
[] Cuba
[] Other West Indies country
[] United Kingdom
[] Canada
[] India
[] Other Commonwealth country
[] U.S.A.
[] Panama
[] Other Central American country
[] China
[] Not stated
[] Other country

13. Race:

[] Negro/black
[] East Indian
[] Chinese
[] Syrian/Lebanese
[] White
[] Mixed/negro
[] Other mixed
[] Other
[] Not stated

14. Religion:

[] Anglican
[] Baptist
[] Plymouth Brethren
[] Church of God of Prophecy
[] Methodist
[] Moravian
[] Pentecostal
[] United Church
[] Roman Catholic
[] Seventh Day Adventist
[] Jehovah's Witness
[] Rastafarian
[] Salvation Army
[] Jewish
[] African Methodist Episcopal (Zion)
[] Muslim/Hindu
[] Dis. Of Christ
[] Other
[] None
[] Not stated

Section 3: Migration[All persons]
15. Number of years lived in this parish: _ _
16. Parish last lived in:

[] Saint Elizabeth
[] Manchester
[] Clarendon
[] Saint Catherine
[] Kingston
[] Saint Andrew
[] Saint Thomas
[] Portland
[] Saint Mary
[] Saint Ann
[] Trelawney
[] Saint James
[] Hanover
[] Westmoreland
[] Not stated

17. Number of parishes ever lived in:

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8 or more
[] Not stated

18. Year of immigration:

[This question was asked of foreign-born persons]
[] Before 1960
[] 1960-69
[] 1970-72
[] 1973-75
[] 1976
[] 1977
[] 1978
[] 1979
[] 1980
[] Not stated

Section 4: Education[All ages]
19. Type of school or university now being attended:

[] None
[] Nursery infant
[] Primary
[] Secondary
[] University
[] Other
[] Not stated

20. Attendance at school or university/special school:

a. Full / part time student:
[] Full time student
[] Part time student
[] Not applicable
[] Not stated
b. Disability:
[] Blind
[] Deaf
[] Other physically handicapped
[] JAMAL (Jamaican Movement for the Advancement of Literacy)
[] Not stated

21. Highest level of educational attainment (including persons still at school):

a) Type of school/university:
[] None
[] Nursery infant
[] Primary
[] Secondary
[] University
[] Other
[] JAMAL (Jamaican Movement for the Advancement of Literacy)
[] Not stated
b) Years of schooling:
[] 0
[] 1-2
[] 3-4
[] 5-6
[] 7
[] 8
[] 9
[] 10
[] 11+
[] Not stated
c) Exam passed:
[] None
[] J.S.C. (5) or 3rd JLCL
[] G.C.E. (O) 3-4
[] G.C.E. (O) 5 S.C. OR G.C.E. (A) 1-2
[] G.C.E. (A) 3 or more or higher schooling
[] Dip
[] Degree
[] Other
[] Not stated

Section 5: Vocational training[All persons age 14 and older]
22. Occupation for which trained or being trained: _______
23. Method by which vocational training [was] acquired:

a. Type of training
[] On the job
[] Private study
[] Institutional training
[] Other
[] Not stated
b. Status
[] Being trained
[] Training completed
[] Not stated

24. Period of training

[For persons whose training has been completed]
[] Under 1/2 year
[] 1/2 year -1 year
[] 1- 1 1/2 years
[] 1 1/2 - 2 years
[] 2- 2 1/2 years
[] 2 1/2 -3 years
[] 3 - 3 1/2 years
[] 3 1/2- 4 years
[] 4 years and over
[] Not stated

Section 6: Economic activity[All persons age 14 and older]
[Questions 25-29 refer to the past week]
25. Economic situation during past week

[] Worked
[] Seeking first job
[] Other seeking work
[] Wanted work and available
[] Home duties
[] Student
[] Retired
[] Disabled
[] Other
[] Not stated

26. Hours worked during the past week: _ _
27. Worker or occupational status during past week:

Worked for others:
[] Government
[] Private enterprise
[] Private household
[] Unpaid worker
Has own business/farm:
[] With paid help
[] Without paid help
[] Did not work
[] Not stated

28. Main type of job or occupation during past week/in last job: _______
29. Industry or type of business during past week/in last job: _______
[Questions 30-31 refer to the past year]
30. Number of months worked during past 12 months: _ _

[] Not stated

31. Main activity during past 12 months:

[] Worked
[] Seeking first job
[] Other seeking work
[] Wanted work and available
[] Home duties
[] Student
[] Retired
[] Disabled
[] Other
[] Not stated

Section 7: Fertility[Females age 14 and older not attending school full-time]
32. Number of live born children ever had: _ _

[] Not stated

33. Number of children still alive: _ _

[] Not stated

34. Age of the mother at the birth of her first live-born child: _ _

[] Not applicable
[] Not stated

35. Age of the mother at the birth of her last live-born child: _ _

[] Not applicable
[] Not stated

36. Number of live-births/stillbirths during the past 12 months:

a) Live births:
[] 0
[] 1
[] Twins
[] 2
[] 3+
[] Not stated
b) Still births:
[] 0
[] 1
[] 2+
[] Not stated

37. Union status- at present or at age 45:

[] Married
[] Common law
[] Visiting
[] No longer living with husband
[] No longer living with common law partner
[] Never had husband or common law partner
[] Not stated

38. Duration of the union (completed years): _ _

[] Not applicable
[] Not stated

Section 8: Housing[The head of the household only]
39. Type of tenure:

[] Owned
[] Leased
[] Private rented
[] Rent- free
[] Squatted
[] Government rented
[] Other
[] Not stated

40. Number of rooms:

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7 and over
[] Not stated

41. Water supply:

[] Public piped into dwelling
[] Public piped into yard
[] Private piped into dwelling
[] Private catchment, not piped
[] Public stand pipe
[] Public tank
[] Other
[] Not stated

42. Toilet facilities:

a. Sharing:
[] Shared
[] Not shared
[] None
[] Not stated
b. Type:
[] Pit
[] W.C. linked to sewer
[] W.C. not linked to sewer
[] Other
[] Not stated

43. Type of lighting/fuel used for cooking:

a. Lighting:
[] Electric
[] Kerosene
[] Other
[] Not stated
b. Cooking:
[] Gas
[] Electricity
[] Wood/charcoal
[] Kerosene
[] Other/none
[] Not stated

Section 9: Check[All persons]
44. Where did individual spend census night?

a. Locally or abroad:
[] This household
[] Elsewhere in country
[] Abroad
b. Parish in Jamaica:
[] Saint Elizabeth
[] Manchester
[] Clarendon
[] Saint Catherine
[] Kingston
[] Saint Andrew
[] Saint Thomas
[] Portland
[] Saint Mary
[] Saint Ann
[] Trelawney
[] Saint James
[] Hanover
[] Westmoreland
[] Not stated

Section 10: Income[Persons age 14 and older]
46. Total income:

a) Pay period:
[] Week
[] Fortnight
[] Month
[] Quarter
[] Year
b) Amount ($): _ _ _ _