Questionnaire Text

Questionnaire form view entire document:  text  image

For person five years old or more


19. Religion

What is the religion of this person? Circle only one answer.

1 None
2 Catholic
3 Other religion
_____Write the name of the religion

Questionnaire instructions view entire document:  text  image

19. Religion

When the religion is other than Catholic, write it as it is reported. If the answer is "Christian", or "Evangelical", or "Protestant", ask the name of the denomination, congregation, or religious group to which they belong and write this in the space for other religion.