Prepared pursuant to the Census (Great Britain) Act, 1900
This space to be filled up by the Enumerator.
____City, town, village, or hamlet
____Street, square, etc. or road
____Name or No. of house
____Number of rooms with one or more window
____ Name of Occupier
In compliance with the Census Act, this schedule must be filled up by the occupier or person in charge of the dwelling.
If a house be let or sub-let to separate persons or families each occupier of a separate tenement or apartment must make a return for his own portion of the house upon a separate Schedule.
Before filling up the schedule all the instructions printed in the headings and on the back must be read.
This schedule will be called for on Monday, April 1st, by the appointed enumerator.
In order that he may not be delayed, the answers must be written in the proper columns early on the morning of that day. It is the duty of the enumerator to complete the return if defective, and to correct it if erroneous. The occupier, if unable to write in the particulars himself, may allow another person to do so.
The return is required for carrying out the provisions of the Census Act. The contents of the schedules will be treated as confidential; they will be published in general abstract only, and strict care will be taken to that the returns are not used for the gratification of curiosity, or for other purposes than those of the census.
Any person who refuses to give information, or who willfully gives false information as to any of the required particulars, is liable, on summary conviction before justices, to a fine not exceeding five pounds.
(See examples for filling up a schedule printed on the back hereof)
1. Name and Surname
This schedule must include any person dwelling in this house or dwelling on the night of March 31st, and alive at midnight; and also any person who, although not in the house during the Census Night, arrived on the morning of Monday, April 1st, and had not been enumerated elsewhere. No one else is to be included. No child born after midnight on Sunday, March 31st, to be included.
Write first the name of the head of the family, followed by the names of his wife, children, and other relatives; then the names of any visitors, boarders, and servants.
____ Relation to head of family
____ Condition as to marriage
4. Age last birthday and sex
Insert opposite each name the ages of males in column headed "males" and those of females in the column headed "females". For infants under one year state the age in months, writing "under 1 month", "1 month", "2 months", etc.
5. Profession or occupation
State the occupation, if any, of each person (whether man, woman, or child). For those engaged in any trade or industry, state the particular brand, and also the material worked or dealt in.
The instructions on the back of the schedule must be carefully read before this column is filled up.
1. The precise nature of the occupation must be inserted in column 5, in accordance with the instructions given below.
2. A person following more than one occupation should state each of them in the order of their importance. Magistrates, members of parliament, and officials may state their official title, but should not omit to return their profession or ordinary occupation, if they have any.
3. Vague terms, such as merchant, broker, agent, manufacturer, contractor, manager, superintendent, Forman, dealer, apprentice, artisan, mechanic, machinist, machine worker, factory hand, operative laborer, etc., must not be used alone. Full and distinctive description of the occupation must be given.
4. Children attending school and also engaged in a trade or industry should be described as following the particular trade or industry.
5. The occupiers' attention is called to the heading of column 7, in which column the words "at home" should be entered opposite the names of persons engaged in any trade or industry carried on at home.
6. The Army, navy, and civil service - persons in these services should state their rank or grad and the branch of the service to which they belong.
7. Ministers of religion- Clergymen of the Church of Scotland should return themselves as "Minister of ____ Pariah," "Assistant Minister of ___Parish," or "Minister of Established Church (no charge." Priests and Ministers of other religious communities should state to what community they belong - "Minister of ____United Free Church," "Minister of ____Independent Chapel" etc. Episcopalism Clergyman, Roman Catholic Priests, and Ministers of Foreign Churches to return themselves as such, and to state the name of the church or chapel, if any, in which they officiate. Local or occasional preachers should return their ordinary occupation, but may also add the fact of their being preachers.
8. Legal profession - members of this profession should state whether they are barristers, solicitors, articled clerks, barristers' clerks, solicitors' clerks or law clerks, etc. according to circumstances.
9. Members of various branches of the medical profession should state whether they are duly registered practitioners, and whether they practice as physician, surgeon, general practitioner, dentist, etc.
10. Professors, teachers, etc. should state the branch of science or art or knowledge which they follow. Artists also should state the art which they cultivate.
11. Students of theology, law, medicine, or other branches of knowledge should return themselves as such.
12. Scholars- children or young person's attending a school, or receiving regular instruction at home (and not engaged in a trade or industry), to be returned as "scholars".
13. Sons or other relatives of farmers employed on the farm should be returned as "farmer's son", "farmer's brother", etc.
14. Agricultural laborers should be entered according to the particular work on which they are usually engaged - such as "shepherd", "ploughman", "hind", "carter on farm", "horse keeper on farm", "cattleman on farm", "stockman on farm", "ordinary agricultural laborer", etc. the term "laborer" must not be used by itself to describe an "agricultural laborer".
15. Shopkeepers and shop-assistants should return themselves as such and should also state their branch of business - as, "grocer-shop-keeper", "draper's assistant", etc. persons wholly or principally engaged in manufacture or repair - such as "journeymen bakers", "tailors' cutters", "watchmakers", "bootmakers" etc. - should return themselves as such and not as "shopkeepers" or "shop-assistants".
16. Managers, foremen, superintendents, over-lookers, etc., should state the special branch of trade in which they are employed.
17. Nurses - the term "nurse" by itself is too indefinite. The kind of nurse should be stated as "hospital nurse", "sick nurse", "monthly nurse", "nurse (domestic)", etc.
18. Domestic servants should be entered according to the nature of their service, adding in all cases "domestic". Examples: "coachman - domestic:", "gardener - domestic:", "cook - domestic". coachmen, gardeners, etc., not in domestic service should describe themselves as "coachman (not domestic)", "market gardener", etc.
19. Engineers should fully state the nature of their employment. Civil, mechanical, electrical, and mining engineers should describe themselves as such. Engine and machine makers should specify the precise branch of the trade in which they are employed - as "steam-engine maker - fitter". engine-drivers, stokers, firemen, should state whether they drive or stoke railway engines, ship engines, or stationary engines, or whether they are furnace stokers - as "stoker on steam-ship", "railway engine-driver", "gas stoker", "furnace stoker at potteries".
20. Artisans, mechanics, and workers in manufactories should state not only the general name, but also the particular branch of the industry in which they are engaged, naming where possible, the material used or article made, thus - "brass founder", "silk-throwster", "and watchmaker - finisher "," printer compositor". Such terms as founder, finisher, printer, throwster, machinist, etc., must not be used alone. Sewing machinists should name the article they machine - as, "boot machinist", "shirt machinist", etc.
21. weavers, spinners, bleachers, dyers, etc., should invariably state the material in which they work and the precise process in which they are engaged - such as, "cotton-spinner", "silk weaver", "cotton card-room hand", "wool-winder", etc.
22. Miners and quarrymen should always state the kind of mine or quarry in which they work, and the nature of their employment in or about the mine or quarry - as, "coal-miner-hewer", "lead-miner", "slate-quarryman". The term "miner" or "quarryman" should never be used alone.
23. Laborers, porters, carters, should specify the nature of their employment - as, "railway porter", "navvy", "bricklayer's laborer", "laborer in ship yards", "railway carter", "and general laborer". The term "laborer", "porter", etc., should never be used alone.
24. Retired - persons who have retired from their profession or occupation should state their former calling. With the addition of the word "retired" - as. "Retired farmer", "retired grocer", "retired blacksmith".
25. living on own means - persons neither following nor having retired from a profession of occupation, but deriving their income from private sources, should return themselves as "living on own means". Such terms as "gentleman", "esquire", etc., must not be used.
 2 Worker (that is a worker for an employer); or
 3 Own account (that is, neither employer nor working of employer, but working on own account).
____ At home
 1 If in England or Wales, the county and town, or Parish.
 2 If in Scotland or Ireland, the name of the country.
 3 If in a British colony or dependency, the name of the colony or dependency.
 Subject", a "Naturalized British Subject", or a "foreign subject", specifying nationality such as "French, German, etc."
____ Where born
____Gaelic and English
 2 Blind,
 3 Lunatic,
 4 Imbecile, feeble-minded
Write the precise infirmity, if any, opposite the name of the person; and if the infirmity dates from childhood, add "from childhood". Do not use such a general term as "Afflicted" or "Infirm".
I declare the foregoing to be a true return, according to the best of my knowledge and belief.
Witness my hand,