Schedule No. 1 -- Population


State __________, County ________________.

Township or other division of county [Insert name of township, town, precinct, district, or other civil division, as the case may be] ______.
Name of institution, _____________________.
Name of incorporated city, town, or village within the above-named division, ___________.
Ward of city, ___________________________.



Enumerated by me on the __ day of June, 1900, ____________________________, Enumerator


Location:
In cities: street; house number.

1. ____ Number of dwelling-houses in the order of visitation.

2. ____ Number of family, in order of visitation.

3. ____ Name of each person whose place of abode on June 1, 1900, was in this family. Enter surname first, then the given name and middle initial, if any. Include every person living on June 1, 1900. Omit children born since June 1, 1900.



4. ____ Relationship of this person to the head of the family.


Personal description:


5. ____ Color or race.



6. ____ Sex.



7. ____ Date of birth: month, year.
8. ____ Age at last birthday.



9. ____ Whether single, married, widowed, or divorced.

10. ____ Number of years married.



11. ____ Mother of how many children.
12. ____ Number of these children living.

Nativity:
Place of birth of each person and parents of each person enumerated. If born in the United States, give the State or Territory; if of foreign birth, give the Country only.



13. ____ Place of birth of this person.



14. ____ Place of birth of father of this person.



15. ____ Place of birth of mother of this person.

Citizenship:



16. ____ Year of immigration to the United States.



17. ____ Number of years in the United States.



18. ____ Naturalization.



Occupation, Trade or Profession:
Of each person ten years of age and over:
19. ____ Occupation.
20. ____ Months not employed.


Education:


21. ____ Attended school (in months).



22. ____ Can read.
23. ____ Can write.



24. ____ Can speak English.



Ownership of Home:



25. ____ Owned or rented.



26. ____ Owned free or mortgaged.



27. ____ Farm or house.



28. ____ Number of farm schedule.