Census Of England And Wales, 1911

CENSUS OF ENGLAND AND WALES, 1911.

Number of Schedule______________

(To be filled up by the Enumerator

after collection.)

Before writing on this schedule please read the Examples and the Instructions given on the other side of the paper, as well as the headings of the Columns. The entries should be written in ink.

The contents of the Schedule will be treated as confidential. Strict care will be taken that no information is disclosed with regard to individual persons. The returns are not to be use for proof of age, as in connection with Old Age Pensions, or for any other purpose

than the preparation of Statistical Tables.

NATIONALITY

AGE

RELATIONSHIP

PROFESSION or OCCUPATION

BIRTHPLACE

of every Person

LANGUAGE

(Last Birthday)

NAME AND SURNAME

PARTICULARS as to MARRIAGE.

INFIRMITY.

to Head of

born in a

of Persons aged ten years and upwards.

of every Person.

SPOKEN.

and SEX.

Family.

Foreign Country.

Whether Employer,

(1) If able to

of every Person, whether Member

If any person

Industry or Service with

Whether

Worker,

State, for each Married Woman

Personal Occupation.

speak English

Working at

included in this

of Family, Visitor, Boarder

which worker is connected.

or Working on

entered on this Schedule, the

State whether:

Home.

only, write

(1) If born in the United Kingdom,

Schedule is:

For Infants

Own Account.

or Servant, who

(1) “British subject

number of:

“English.”

write the name of the County,

(1) “Totally

under one year

Write

by parentage.”

and Town, or Parish.

(2) If able to

Write opposite the

Deaf ” or “Deaf

(1) passed the night of Sunday,

state the age

“Single,”

This question should generally

(2) If born in any other part of the

(2) “Naturalized

State whether

name of each person

speak Welsh

and Dumb,”

in months as

be answered by stating the

April 2nd, 1911, in this

“Married,”

Children born alive to

Com-

engaged in any

British Empire, write the name

British subject,”

only, write

“Head” or

The reply should show the precise branch

(2) “Totally

business carried on by the

“under one

“Widower,”

present Marriage.

Trade or Industry,

of the Dependency, Colony,

giving year of

dwelling and was alive at

pleted

Write the

“Welsh.”

“Wife,” “Son,”

of Profession, Trade, Manufacture, &c.

Blind,”

(1) “Employer”

employer. If this is clearly

etc., and of the Province or

month,”

or

(If no Children born

words

naturalization.

years the

(3) If able to

“Daughter,” or

(that is employing

(3) “Lunatic,”

midnight, or

state.

“one month,”

alive write “None” in

shown in Col. 10 the question

“At Home”

“Widow,”

OR

present

persons other than

speak English

(4) “Embecile”

other Relative,

If engaged in any Trade or Manufacture,

(3) If born in a Foreign Country,

opposite the

etc.

need not be answered here.

(2) arrived in this dwelling on the

opposite the

Column 7.)

domestic servants),

(3) If of foreign

and Welsh

Marriage

writed the name of the Country.

or “Feeble-

“Visitor,”

the particular kind of work done, and

or

name of each

No entry needed for Domestic Serv-

names of

nationality,

(4) If born at sea, write “At Sea.”

write “Both.”

morning of Monday, April

has

minded,”

“Boarder,” or

(2) “Worker” (that

person

the Article made or Material worked or

ants in private employment.

state whether

all persons

Note. - In the case of persons

No entry to be

lasted.

is working for

carrying on

state the infirmity

“Servant.”

dealt in should be clearly indicated.

3rd, not having been

If employed by a public body

born elsewhere than in England or

“French,”

aged 15 years

an employer),

made in this

Total

Trade or

opposite that

If less than

Children

Children

or

Wales, state whether “Resident” or

(Governmen, Municipal, etc.)

“German.”

enumerated elsewhere.

and upwards.

Industry at

column for child-

Children

person’s name,

one year,

who

(See Instructions 1 to 8 and Examples

(3) “Owner Account”

Ages

Ages

still

“Visitor” in this Country.

state what body.

home.

“Russian,”

ren under three

and the age at

No one else must be included.

write

Born

(that is neither

have

of

of

on back of Schedule.)

Living.

(See Instruction 9 and Exam

etc.

years of age.

employing others

which he or she

Alive.

“under

(For order of entering names see Examples on

Died.

Males.

Females.

nor working for a

ples on back of Schedule.)

became afflicted

one.”

trade employer).

back of Schedule.)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

(To be filled up by, or on behalf of, the Head of Family or other person in occupation, or in charge, of this dwelling.)

(To be filled up by the Enumerator.)

I declare that the Schedule is correctly filled up to the best of my knowledge and belief.

Write below the Number of Rooms in this

I certify that:

Total.

(1.) All the ages on this Schedule are entered in the proper sex columns.

Dwelling (House, Tenement or Apartment).

(2.) I have counted the males and females in columns 3 and 4 separately,

Males.

Females.

Persons.

Count the kitchen as a room but do not count

Signature_________________________________________________________

and have compared their sum with the total number of persons.

scullery, landing, lobby, closet, bathroom;

(3.) After making the necessary enquiries I have completed all entries on

nor warehouse, office, shop.

the Schedule which appeared to be defective, and have corrected

such as appeared to be erroneous

Postal Address_____________________________________________________

Initials of Enumerator______________________