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Commonwealth Caribbean Population Census 1970

Form C1
Confidential

1. Identifying Number

County _
Parish _ _
Constituency _ _
Town/Special area _ _
E.D. Number _ _ _
Household number _ _ _

2. Name of individual

____ Surname
____ First name
____ Middle

Section 1. Identity

[Question 3-4 asked of all persons.]

3. Household number _ _ _

4. Individual number within household _ _

Section II. Characteristics
[Questions 5-12 asked of all persons.]

5. Relationship to head of household

[] Head
[] Spouse/ Partner
[] Child of head/spouse
[] Other relative
[] Boarder/relative
[] Domestic employee/relative
[] Other
[] Not stated

6. Sex

[] Male
[] Female

7. Age (in complete years) _ _

8. Marital Status

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

9. Usual residence
9a. Local or foreign

[] This household
[] Elsewhere in country
[] Abroad
[] Not stated

9b. County

[] Saint George
[] Caroni
[] Victoria
[] Saint Patrick
[] Tobago
[] Nariva
[] Mayaro
[] Saint David
[] Saint Andrew
[] Not stated

9c. City of birth ____

9d. Foreign country

[] United Kingdom
[] United States of America
[] Canada
[] Barbados
[] Guyana
[] Jamaica
[] Other Caribbean ____
[] Other country not in the Caribbean ____
[] Unknown

10. Birth place
10a. County of birth

[] Saint George
[] Caroni
[] Victoria
[] Saint Patrick
[] Tobago
[] Nariva
[] Mayaro
[] Saint David
[] Saint Andrew
[] Not stated

10b. City of birth ____

10c. Foreign country of birth

[] United Kingdom
[] United States of America
[] Canada
[] India
[] Venezuela
[] Other in Caribbean or Latin America
[] Barbados
[] Jamaica
[] Guyana
[] Antigua and Barbuda
[] Dominica
[] Grenadines
[] Saint Lucia
[] Saint Vincent
[] Other Commonwealth Caribbean Country
[] Other country ____
[] Not stated

11. Race

[] Negro/Black
[] East Indian
[] Chinese
[] American Indian
[] Portuguese
[] Syrian/Lebanese
[] White
[] Mixed
[] Other races
[] Not stated

12. Religion

Score specified religion if applicable. If religion not specified above, write on the line.
[For office use only coding omitted.]

[] Anglican
[] Baptist (Orthodox)
[] Brethren
[] Church of God
[] Methodist
[] Morvan
[] Pentecostal
[] Presbyterian Congregation
[] Roman Catholic
[] Seventh Day Adventist
[] Not specified ____

Section III. Migration

[Question 13-15 asked of all persons.]

13. Number of years lived in this county _ _

14. County last lived in

[] Saint George
[] Caroni
[] Victoria
[] Saint Patrick
[] Tobago
[] Nariva
[] Mayaro
[] Saint David
[] Saint Andrew
[] Not stated

City ____

15. Number of county ever lived in

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 9 or more

16. Year of Immigration

[Question 16 asked of foreign born only.]

[] Before 1943
[] 1943-1946
[] 1947-1953
[] 1954-1958
[] 1959-1960
[] 1961-1963
[] 1964-1965
[] 1966-1968
[] 1969-1970
[] Not stated

Section IV. Education

[Questions 17-19 asked of all ages.]

17. Type of nonvocational school or university now being attended

[] Nursery/ Infant
[] Primary
[] Secondary
[] Private study
[] University
[] Other
[] None
[] Not stated

18. Attendance at school or university

[] Full time student
[] Part time student
[] Not applicable

19. Highest level of educational attaimnet
[Question 19 includes persons still in school]

19a. Type of school/university

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

19b. Years of primary schooling

[] 0
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7 or more
[] Not stated

19c. Exam passed

[] None
[] JSC (5) or 3rd J. LCL
[] GCE (0) 1/2
[] GCE (0) 3/4
[] GCE (0) 5 or S.C. Or GCE (A) 1
[] GCE (a) 2 or more
[] DIP.
[] Degree
[] Other
{] Not stated

Section V. Vocational Training

[Question 20-22 asked of all person 10 years and over.]

20. Occupation for which trained or being trained ____

21. Method by which vocational training acquired

21a. Method of training

[] On job
[] Private study
[] Instituational training
[] Other
[] Not stated

21b. Training status

[] Being trained
[] Training completed

22. Period of training

[Question 22 asked only for person whose training has been completed indicated in 21b.]

[] Under 0.5
[] 0.5 - 1 year
[] 1- 1.5 years
[] 1.5 - 2 years
[] 2 - 2.5 years
[] 2.5 - 3 years
[] 3 - 3.5 years
[] 3.5 - 4 years
[] 4 - 4.5 years
[] 4.5 years and over

Surname ____
First name ____
Middle name ____

Section VI. Economic Activity

[Questions 23-29 asked of all persons 10 years and over.]

23. Main activity during past 12 months

[Question 23 refers to activity in the past year.]

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

24. Worker or occupational status during past year

[Question 24 refers to activity in the past year.]

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

25. Months worked during past 12 months

[] Under 2
[] 2-3
[] 4-5
[] 6-7
[] 8-9
[] 10-11
[] Full year
[] Not stated

26. Main type of job or occupation during past 12 months ____

[For office use only occupational coding omitted.]

27. Industry or type of business during past 12 months ____

[For office use only industrial coding omitted.]

28. Economic situation during past week

[] Worked
[] With job, not working
[] Looked for work
[] Home duties
[] Student
[] Retired
[] Disabled
[] Other
[] Not stated

29. Total number of hours worked (including overtime) during past week _ _

Section VII. Fertility

[Questions 30-35 asked only of females 14 years and over.]

30. Number of liveborn children ever had _ _

31. Age of mother at birth of first liveborn child _ _

32. Age of mother at birth of last liveborn child _ _

33a. Number of live births during past 12 months

[] 0
[] 1
[] Twins
[] 2
[] 3+
[] Not stated

33b. Number of stillborns during past 12 months

[] 0
[] 1
[] 2+
[] Not stated

34. 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 a husband or partner
[] Not stated

35. Duration of union (complete years) _ _

Section VIII. Housing

[Questions 36-43 asked of the head of the household only.]

36. Type of dwelling

[] Separate house
[] Flat/ apartment
[] Barracks
[] Out room
[] Part of common buildings
[] Other private
[] Group dwelling
[] No fixed address
[] Not stated

37. Type of tenure

[] Owned
[] Leased
[] Rented
[] Rent free
[] Squatted
[] Other
[] Not stated

38. 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

39. Toilet facilities
39a. Toilet facilities

[] Shared
[] Not shared
[] None

39b. Toilet Facilities

[] Pit
[] WC linked to sewer
[] WC not linked to sewer
[] Other

40. Year when dwelling built

[] 1970
[] 1969
[] 1968
[] 1960-1967
[] 1951-1959
[] 1950 or earlier
[] Not stated

41. Material of outer walls

[] Wood
[] Concrete
[] Stone
[] Brick
[] Nog
[] Wattle/adobe
[] Wood and concrete
[] Other

42. Number of rooms

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

43. Type of lighting/fuel used for cooking

43a. Type of lighting

[] Electricity
[] Kerosene
[] Other

43b. Type of fuel used for cooking

[] Gas
[] Electricity
[] Wood/Charcoal
[] Kerosene
[] Other/ None

Section IX. Census

[Question 44 asked of all persons.]

44. Where did individual spend census night? ____

44a. Locally or abroad

[] This household
[] Elsewhere in country
[] Abroad

44b. County

[] Saint George
[] Caroni
[] Victoria
[] Saint Patrick
[] Tobago
[] Nariva
[] Mayaro
[] Saint David
[] Saint Andrew
[] Not stated

Section X. Income

[Question 46 asked of persons 10 years and over.]

46. Total income

46a. Payperiod

[] Week
[] Fortnight
[] Month
[] Quarter
[] Year
[] Not stated

46b. Amount ($) _ _ _ _