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1 9 70
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SEC. SLT
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FOiLt'vI-CI
CONFIDENTIAL
1-
23
M A I N ACTIVITY DURING PAST 1 2 M O N T H S
.........................
24 b + O F I K E D F O R
24 W O R K E R O R O C C U P A T I O N A L STATUS
DURING PAST YEAR
P
A
GOVT
OTHERS
HL s
...............
o\: r i
fiOl.1
Ut;PAlD
GOVT
YiO?KER
PAID
HELP
...............
~
R U5 i r i F < s I F s K t 1
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STATED
..........
..........
~
-
7
DID
1-3
'<aOr?K
/OUT
PCIlD
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25 M O N T H S W O R K E D DURING PAST 12
MONTHS
26
S
M A I N TYPE O F J O B O R O C C U P A T I O N
D U R I N G PAST 12 M O N T H S (WRITE A S G I V E N )
T
ALL
PERSONS
1 0 YEARS
OLD
AND
OVER
_.
o
[FOR OFFICE USE ONLY]
Y
E
A
27
INDUSTRY O R TYPE O F BUSINESS DURING
PAST 1 2 M O N T H S (WRITE A S G I V E N )
R
[ F O R O F F I C E U S E ONLY]
-
'VJ 28 E C O N O M I C S I T U A T I O N DURING PAST WEEK
4 E 29
TOTAL NUMBER O F HOURS WORKED
SE
FK
SEC.
( I N C L U D I N G OVERTIME) D U R I N G PAST WEEK
30
PII.
N U M B E R O F LIVEBORN C H I L D R E N EVER HAD
31 A G E O F M O T H E R A T BIRTH O F FIRST
LIVEBORN C H I L D
32 A G E O F M O T H E R A T BIRTH O F LAST
LIVEBORN C H I L D
3 3 N U M B E R O F LIVE BIRTHS/STILLBIRTHS
D U R I N G PAST 1 2 M O N T H S
FEMALES
14 YEARS
AND OVER
34 UNION STATUS-AT
PRESENT
O R A T A G E 45
34
L'DIIRIED
cct,"':'I
LA#
VISITI!.Z
...............
..............
1.3 L C t l i t R
LIV,I\Z~~;lTH
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f'AftTt.:R
t.0 L O ' I C E R
LIVI1.S t < I T H
C L IARTI.CR
.....
.....
.....
.....
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~ . .
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ST-TCD
.....
...
35
D U R A T I O N O F UNION (COMPLETED YEARS)
SEC.
36
Pm
TYPE O F D W E L L I N G
37 TYPE O F TENURE
38
THE
HEAD
OF
THE
HOUSEHOLD
ON LY
W A T E R SUPPLY
39
T O I LET FACILITIES
40 YEAR W H E N D W E L L I N G BUILT
4 1 M A T E R I A L O F OUTER W A L L S
42
NUMBER O F R O O M S
43 TYPE O F L I G H T I N G / F U E L USED FOR C O O K I N G
SEC.
IX
ALL
PERSONS
SEC.
PARISH IN B A R B A D O S
ONLY]
X
PERSONS
10 YEARS
AND
OVER
TOTAL
INCOME
I
A M O U N T (S)
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W H E R E DID
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NIGHT
45 [ F O R O F F I C E USE
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FORM-CI
CONFIDENTIAL
I C t l bi90434
PRINTED IN U S A
SEC.
I
P
E
A R
L S
L O
N
S
SEC.
II
3
HOUSEHOLD NUMBER
4
1~0.1
ILOZ 1201 130:
14Ck
150.
160. 170. 180: 190:
II0.I
:!
I
112::
:IC1
1151
116::
INDIVIDUAL NUMBER WITHIN HOUSEHOLD
5
5
RELATIONSHIP TO HEAD OF HOUSEHOLD
1171:
118:
119.1
CHILD
SPOUSE/
OF
OTHER DOARDERI
H E A D PARTt.ER HD/SP
REL
REL
.........................
.........................
6
SEX
II311
DOb'ESTIC
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STATED
OTHER
_._._._._.
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.....
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---
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27
(b)
USUAL
A
9(b)
ST J O 5
S T Ah3
S T PETER
O'TWII
PARISH IN BARBADOS
O'TWt4
____.
ST NIC
ri/ 5
ST LUCY
_____
..........
---------
PARISH IN BARBADOS
7
___-___ _- -
.....
.....
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ST
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.........................
.........................
RACE
12
SCORE SPECIFIED RELIGION IF APPLICABLE
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(3RTH) EiiETh7EN
CIIUGCH
CF
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NETH3ST
.........................
SYR IA N/
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.........................
.........................
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RO'IAt1
CATH
SEV
DAY
LDVTST
........................
.........................
.........................
RELIGION
IF RELIGION NOT SPECIFIED ABOVE (WRITE)
--- - - - - -
- - - - - - - -- - - - - - - - - _ - - - - - - - - - - - -
[FOT: OFFICE USE Oi~lL:']
SEC.
IE 13
A
L
l3
II01
1101
120
130
140.
150
-60.
1-70:
180-
ST
ST
ST
190-
NUMBER OF YEARS LIVED IN THIS PARISH
14
P
36
PARISH LAST LIVED IN
R
s
ß'TIN
S T t'sC
CH
CH
ST
ST
SEP
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37
02. .ED
TE
A
L
L
16
16
YEAR OF IMMIGRATION
I/
TYPE OF NONVOCATIONAL SCHOOL OR
UNIVERSITY NOW BEING ATTENDED
BEFCGE
1343
1943-
46
134753
1954-
58
135960
.
........................
.........................
1961-
1964-
1966-
1969-
N3T
63
€5
€8
70
STLTED
.........................
38
_-
PUE
PIPED
G
E
S
SEC. TT
ALL
PERSONS
10 YEARS
AND
OVER
PU3
PlPiC
ItITO C A E L I N T O Y D
.........................
PE'dTED
FGZE
PRIV
FIPEFC
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ST,'.3
PIPE
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TP. i 3
42
43!a!..
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1350 CR E A R L I E R
.....
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.........................
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ST'TLD
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LI'.'E3_
t c ~ . ~ CR T t E R
PIT
....................
...................
t.C'.E
1370
1969
1068
1960-67 1051 59
.........................
.
.......................
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....................
...............
41
OTt'LR
-
....................
...............
40
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STmTE3
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SIIARED
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..........
SIUiTTED
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PI'IV
.........................
.........................
.....
.........................
.........................
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FOREIGN
ORN ONLY
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.....
...............
S
PT CF
CO'l'l
CJT
P3C1'
fllRRACKS
...............
O
SEC.
FLLT/
APTllT
ACO: E
PRCV
113 1
STrTED
.....
.....
I*"LLJ
1
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.....
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I(b)
OTHER
CTt* R
CC'.C
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IN..
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C L E C ? C ? ~ C t7 ~ i E ' * 3
C.
C.
2.
3.
2.
3
1
E
INSTRUCTIONS
I . Please use plie ;/2Llacbt-lead pencil supplied w l i e n marking y o u r unswcrs i o ikie quesiions on this
you makc a mistake, erase
form. DO NOT USE INK, BALLPOIN? PEN, OR COLORED PENCIL.
s u r e i o ,Fill a response position (II:::) Gor each
cleanly and h e n fill in ftie answer space you want.
the question applies to Plie individual. Each ansvyer spacc you marlt should be
filled in completely with a blacGc mark, Plie same as s l i o v ~ n
in h e S A ~ U W L E
QUESÏ1Oi+J.
question &ere
SAMPLE QUESTION
M A K E NO E X T R A N E O U S M A R K S O F A N Y K I N D ON THE F O R M
2. Do not rnarGt or write in
3. l"ien
f l i e shaded areas.
'ïhe areas 1:JilI be marked in tiie central office.
you have finished questions 1 through
22,carefully fold
at perGorution and continue
with
questions 23 through 46.
-
4. I ry to make your marks as sliown liere:
DO
nQf make Pllem
-
f'00
lig ht
-
POO
short
:-:I
too long
-
-CI
-
An ideal mark
A readable mark
Too light or poorlycrased
Mark too short
Murktoolong
irtd ~ 9 0 4 3 5
PRINTED IN U S A