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Household schedule for England

Census of England and Wales, 1911

Before writing on this schedule please read the Examples and the Instructions given on the other side of the paper, as well as the headings of the Columns. The entries should be written in Ink.
The contents of the Schedule will be treated as confidential. Strict care will be taken that no information is disclosed with regard to individual persons. The returns are not to be used for proof of age, as in connection with Old Age Pensions, or for any other purpose than the preparation of Statistical Tables.

1. Name and Surname
of every Person, whether Member of Family, Visitor, Boarder, or Servant, who

1. Passed the night of Sunday, April 2nd, 1911, in this dwelling and was alive at midnight, or
2. Arrived in this dwelling on the morning of Monday, April 3rd, not having been enumerated elsewhere.

No one else must be included.
(For order of entering names see Examples on the back of the Schedule.)

2. Relationship to Head of Family
State whether 'Head', or 'Wife,' 'Son,' 'Daughter,' or other Relative, 'Visitor,' 'Boarder,' or 'Servant.'

Age (last birthday) and Sex
For Infants under one year state the age in months as 'under one month,' 'one month,' etc.

3. [ ] Age of males
4. [ ] Age of females

Particulars as to Marriage

5. Write 'Single,' 'Married,' 'Widower,' or 'Widow,' opposite the names of all persons age 15 years and upwards.

State, for each Married Woman entered on the Schedule, the number of:

6. Completed years the present Marriage has lasted. If less than one year write 'under one'.
Children born alive to the present marriage. (If no children born alive write 'None' in Column 7.)
7. [ ] Total Children Born Alive
8. [ ] Children still living
9. [ ] Children who have Died

Profession or Occupation of Persons aged ten years and upwards

10. Personal Occupation.

The reply should show the precise branch of Profession, Trade, Manufacture, etc.
If engaged in any Trade of Manufacture, the particular kind of work done and the Article made or Material worked or dealt in should be clearly indicated.
(See Instructions 1 to 8 and Examples on back of Schedule)

11. Industry or Service with which worker is connected.

This question should generally be answered by stating the business carried on by the employer. If this is clearly shown in Col. 10 the question need not be answered here.
No entry needed for Domestic Servants in private employment.
If employed by a public body (Government, Municipal, etc.) state what body.
(See Instruction 9 and Example on back of Schedule)

12. Whether Employer, Worker, or Working on Own Account.

Write opposite the name of each person engaged in any Trade or Industry
[1] 'Employer' (that is employing persons other than domestic servants), or
[2] 'Worker' (that is working for an employer), or
[3] 'Own Account' (that is neither employing others nor working for a trade employer)

13. Whether Working at Home.

Write the words 'At Home' opposite the name of each person carrying on Trade or Industry at home.

14. Birthplace of every person
[1] If born in the United Kingdom, write the name of the County, and Town or Parish
[2] If born in any other part of the British Empire, write the name of the Dependency, Colony, etc., and of the Province or State
[3] If born in a Foreign Country, write the name the Country
[4] If born at sea, write 'At Sea'

Note: In the case of persons born elsewhere than in England or Wales, state whether 'Resident' or 'Visitor' in this Country.

15. Nationality of each person born in a Foreign Country.
State whether

[1] 'British subject by parentage'
[2] 'Naturalized British subject', giving year of naturalization
[3] If of foreign nationality, state whether 'French', 'German', 'Russian', etc.

16. Infirmity.
If any person included to this Schedule is:

[1] 'Totally Deaf', or ' Deaf and Dumb'
[2] ' Totally Blind'
[3] 'Lunatic'
[4] 'Imbecile' or 'Feeble-minded'

state the infirmity opposite that person's name, and the age at which she or he became afflicted.