Questionnaire Text

Questionnaire form view entire document:  text  image
Chapter F.

For those 5 years of age and older

16. What languages or tongues do you speak?

[] 1 GuaranĂ­
[] 2 Spanish
[] 3 Portuguese
[] 4 German
[] 5 English
[] 6 French
[] 98 Doesn't speak
[] Indigenous language (specify) ____ _ _
[] Other language (specify) ____ _ _
Questionnaire instructions view entire document:  text  image
F. Information about the population
For persons 5 years of age and older

Question 16: What languages or dialects do you speak?
Remember that here you can mark more than one circle.

If the person speaks a language or dialect that is not on the list, you should specify it on the designated space.