Questionnaire Text

Questionnaire form view entire document:  text  image

For those 12 years of age and older
[Applies to questions 18 -19]


19. What is your religion?

Circle the appropriate number:

[] 1 Evangelical Christian
[] 2 Catholic
[] 3 Other (specify) ____
[] 4 None

Questionnaire instructions view entire document:  text  image

For people 12 years of age and older
[Applies to questions 18 -19]


Question No. 19: What is your religion?
Read the question and, depending on the response, circle the corresponding number.
[There is a picture of question 19 in this section of the Enumeration Form.]
Remember the following:

If the person reports another religion, circle the number 3 and on the line "specify", record the name of the religion.
If the person reports not having any religion, circle the number 4.