Form C1: Confidential
Commonwealth Caribbean Population and Housing Census 1991
Section 1: Identification
[For all persons]
Please give me the names of all the persons who usually live in this household. Please give me also the names of all other persons who spent the night of April 7, here. Please give me the name of the head of household first.
First name _____
[Head of household only]
Constituency _ _
Special Area _ _
E.D. Number _ _ _
Housing unit number _ _ _
Dwelling number _ _
Household number _ _
Individual number _ _
1. Characteristics of housing unit
[] Semi-detached
[] Apartment building
[] Townhouse
[] Improvised housing unit
[] Part of commercial building
[] Other
[] Not stated
[] Stone
[] Brick
[] Nog
[] Wattle/Adobe
[] Wood
[] Wood and concrete
[] Wood and brick
[] Other
[] Not stated
[] Shingle, wood
[] Shingle, other
[] Tile
[] Concrete
[] Other
[] Not stated
[] 1985-1989
[] 1980-1984
[] 1975-1979
[] 1970-1974
[] Before 1970
[] Not stated
2. Characteristics of household
[] Leased
[] Private rented
[] Government rented
[] Rent free
[] Squatted
[] Other
[] Not stated
[] Leased
[] Rented
[] Rent free
[] Squatted
[] Other
[] Not stated
[] Public, piped into yard
[] Private, piped into dwelling
[] Private catchment, not piped
[] Public standpipe
[] Public catchment
[] Spring or river
[] Other
[] Not stated
[] WC linked to sewer
[] WC not linked to sewer
[] Other
[] None (go to Question 2.10)
[] Not stated
(b) Are these facilities shared?
[] Not shared
[] Not stated
[] Kerosene
[] Other
[] Not stated
[] Electric
[] Wood/charcoal
[] Kerosene
[] Other
[] None
[] Not stated
[] No (go to Question 2.15)
[] Not stated
[] 2. Female
Age _ _
If not stated, record "99".
[] No (Go to Question 3.1)
[] 2. Female
Age _ _
If not stated, record "99".
Section 3: Characteristics (for all persons)
Parish _ _
Constituency _ _
Special Area _ _
E.D. Number _ _ _
Housing unit number _ _ _
Dwelling number _ _
Household number _ _
Individual number _ _
Name of individual _______
Book number _ _ _ _ _ _
[] Spouse/partner of head
[] Child of head/spouse
[] Spouse/partner of child
[] Grandchild of head/spouse
[] Parent of head/spouse
[] Other relative of head/spouse
[] Domestic employee
[] Other non-relative
[] Not stated
[] Female
a. What is your / [the respondent's] date of birth?
[] Feb
[] Mar
[] Apr
[] May
[] Jun
[] Jul
[] Aug
[] Sep
[] Oct
[] Nov
[] Dec
Year _ _
[] East Indian
[] Chinese
[] White
[] Mixed
[] Other (specify) _____
[] Not stated
[] Baptist
[] Brethren
[] Church of God
[] Jehovah's Witness
[] Methodist
[] Moravian
[] Pentecostal
[] Rastafarian/Ethiopian Orthodox
[] Roman Catholic
[] Seventh Day Adventist
[] United Church
[] Disciples of Christ
[] None
[] Other (specify) _____
[] Not stated
[] 16 years of older
[] Married
[] Widowed
[] Divorced
[] Legally separated
[] Not stated
[] No (Go to Question 4.1)
[] Not stated
[] No (go to Question 4.1)
[] Not stated
[] Hearing only
[] Speech only
[] Physical disability only
[] Multiple disability
[] Slowness at learning or understanding
[] Mental retardation
[] Mental illness
[] Other (specify) ______
[] Not stated
[] Mobility
[] Communication
[] Schooling
[] Employment
[] None
[] Not stated
Section 4: Birthplace and residence
[All persons]
[] No
[] Not stated
[] St. Andrew
[] St. Thomas
[] Portland
[] St. Mary
[] St. Ann
[] Trelawney
[] St. James
[] Hanover
[] Westmoreland
[] St. Elizabeth
[] Manchester
[] Clarendon
[] St. Catherine
[] Not stated
[] Canada
[] U.K.
[] Caribbean Commonwealth
[] Other Commonwealth
[] Other
[] Not stated
[] St. Andrew
[] St. Thomas
[] Portland
[] St. Mary
[] St. Ann
[] Trelawney
[] St. James
[] Hanover
[] Westmoreland
[] St. Elizabeth
[] Manchester
[] Clarendon
[] St. Catherine
[] Not stated (go to Question 4.5)
[] Canada
[] U.K.
[] Caribbean Commonwealth
[] Other Commonwealth
[] Other
[] Not stated
For years before 1900, score "00".
For years before 1900, score "00".
[] St. Andrew
[] St. Thomas
[] Portland
[] St. Mary
[] St. Ann
[] Trelawney
[] St. James
[] Hanover
[] Westmoreland
[] St. Elizabeth
[] Manchester
[] Clarendon
[] St. Catherine
[] Not stated
[All persons]
Interviewer
(i) For children under 4 years, mark "No" at question 5.1 and go to question 8.1
(ii) For persons over 50 years, mark "No" at question 5.1 and proceed from question 5.2 in relation to the last institution attended.
(iii) For persons between ages 30 and 50 years, say: "It is known that some people try to further their education as they get older" before asking question 5.1.
(iv) For all other persons, i.e. 4-29 years old, proceed directly to question 5.1.
[] No
[] Not stated
[] Nursery/infant (go to Question 5.5)
[] Primary/preparatory (go to Question 5.4)
[] All age/elementary (go to Question 5.4)
[] Junior secondary (go to Question 5.4)
[] New secondary (go to Question 5.4)
[] Secondary high (go to Question 5.4)
[] Vocational
[] Commercial/secretarial
[] University (go to Question 5.5)
[] Other tertiary (specify _____)
[] Special school (go to Question 5.4)
[] Other (go to Question 5.4)
[] Not stated (go to Question 5.4)
[] All age/elementary
[] Junior secondary
[] New secondary
[] Secondary high
[] Not stated
[] Standard 1-3, elementary
[] Standard 4-6, elementary
[] Grade 1-4, primary, all age, secondary
[] Grade 5-8, primary, all age, secondary
[] Grade 9-12, primary, all age, secondary
[] Form 1-3, secondary high
[] Form 4-5, secondary high
[] Form 6, secondary high
[] Grade 7-9, secondary high
[] Grade 10-12, secondary high
[] Not stated
[] Full-time
[] Part-time
[] Not stated
Mark "None" for all persons currently attending/last attended nursery/infant and primary/preparatory schools (See Question 5.2).
[] CXC Basic, JSC or JSCE, 3rd JLCL, SSC, JC
[] GCE '0' 1-3, CXC General 1-3, AEB 1-3
[] GCE '0' 4+, CXC General 4+, AEB 4+, SC
[] GCE 'A' 1+, HSC
[] College Certificates and Diplomas
[] Other Certificates and Diplomas
[] Degrees and professional qualifications
[] Other
[] Not stated
[Persons age 14 and older]
[Go to Question 8.1 for persons younger than 14 years]
[] With job not working (go to Question 6.3)
[] Seeking first job (go to Question 6.7)
[] Other, seeking work (go to Question 6.4)
[] Did not seek work but wanted work and available (go to Question 6.4)
[] Student (go to Question 6.7)
[] Home duties (go to Question 6.7)
[] Retired (go to Question 6.7)
[] Disabled, unable to work (go to Question 6.7)
[] Other (go to Question 6.7)
[] Not stated
[] Paid employee (private enterprise)
[] Paid employee (private home)
[] Unpaid worker
[] Own business with paid employees
[] Own business without paid employees
[] Not stated
[] Partially tourism-related
[] Not tourism-related
[] Don't know
[] Not stated
[] Looked for work (go to Question 7.1)
[] Student (go to Question 7.1)
[] Home duties (go to Question 7.1)
[] Retired (go to Question 7.1)
[] Disabled, unable to work (go to Question 7.1)
[] Other (go to Question 7.1)
[] Not Stated
[] 3 to under 6 months
[] 6 to under 9 months
[] 9 to under 12 months
[] 12 months
[] Not stated
[] Not stated
[] $100-199
[] $200-299
[] $300-399
[] $400-499
[] $500-749
[] $750-999
[] $1,000+
[] $400-799
[] $800-1,199
[] $1,200-1,599
[] $1,600-1,999
[] $2,000-2,999
[] $3,000-3,999
[] $4,000+
[] $5,000-9,999
[] $10,000-19,999
[] $20,000-39,999
[] $40,000-59,999
[] $60,000-99,999
[] $100,000+
(Female age 14 and older who are not full-time students at a primary or secondary school)
[] Never married (go to Question 7.3)
[] Widowed, divorced, separated (go to Question 7.4)
[] Not stated
[] No (go to Question 7.4)
[] Not stated
[] Never had a husband or common-law partner (go to Question 7.6)
[] Not stated
[] No (go to Question 7.6)
[] Not stated
[] 65 years old and over (go to Question 8.1)
If "00", go to Question 8.1.
[] No (go to Question 8.1)
[] Not stated
[] Two separated births
[] Twins
[] Three or more
[] Note stated
Male:
[] 2
[] 3+
Female:
[] 2
[] 3+
[] No
[] Not stated
7.14. How many have died? _ _
If not stated, record "99".
Section 8: Where individual spent Census night
[All persons]
[] Another household in Jamaica (go to Question 8.2)
[] Abroad
[] Not stated
8.2. In which Parish was this?
[] St. Andrew
[] St. Thomas
[] Portland
[] St. Mary
[] St. Ann
[] Trelawney
[] St. James
[] Hanover
[] Westmoreland
[] St. Elizabeth
[] Manchester
[] Clarendon
[] St. Catherine
[] Not stated