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FONE circle for the race that the person

considers himself/herself to be.

Indien (Amer.), print the name of

the enrolled or principal tribe.

C Black or Negro

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O Black or Negro

O Indian (Amer.) (Print the name of the

enrolled or principal tribe. 17.

Hawellan

O Guamanian

O Indian (Amer) (Print the na

enrolled or principal tribe.)

O Eskimo

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O Aleut

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Aslan or Pacific lalander (API) O Japanese

Asian or Pactic islander (AP)

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O Asian Indian

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Aslan or Pacific Island O Jap OAN

O Hawaiian

O San

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O Korean

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If Other Aalan or Pacific lelander (APT),

print one group, for example: Hmong Fen, Leotan, Thai, Tongan, Pakistani, Cambodian, and so on..

Other race, print race.

5. Age and year of birth

a. Print each person's age at last birthday.

Pin the matching circle below each box.

O Hewallan

O Samoan

Guamanian

b. Print each person's year of birth and hill the matching circle below each box.

000000 101010

2020

6. Marital status

FONE circle for each person.

7. Is this person of Spanish/Hispanic origin?

PONE dede for each person.

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b. Year of

1080 90

O S ONe

No thot Spanish/Hispanic)

O Yes, Mexican, Mexican-Am

C Yes, Puerto Rican

CY, Cuben

O Yes, other Spanish/Hispanic

EXPLANATORY NOTES

This booklet shows the content of the two 1990 census questionnaires being delivered by mall. The content of these forms was determined after review of the 1980 census experience, extensive consultation with many government and private users of census data, and a series of experimental censuses and surveys in which various alternatives were tested.

Two principal types of data-collection forms a 100-percent questionnaire (or "short form") and a sample questionnaire (or "long form") are being used in the census. Each household receives one of the two questionnaires. Short form - This questionnaire contains 7 population questions and 7 housing questions, shown on pages 1-3 of this booklet. On average, about 5 in every 6 households will receive the short form. For the average household, this form will take an estimated 14 minutes to complete.

Long form - This questionnaire has all of the short-form questions plus housing questions H8 through H26, shown on pages 4 and 5, and population questions 8 through 33, shown on pages 6 and 7. The population questions are repeated for each member of the household but these pages were not reproduced in this booklet. A statistical sample of approximately 1 in every 8 households will receive the long form. For the average household, this form will take an estimated 43 minutes to complete.

An instruction guide accompanies each questionnaire to help the respondents complete the form, and a preaddressed envelope is provided for returning the questionnaire.

For additional information about the 1990 U.S. Census, please write the Director. Bureau of the Census, Washington, DC 20233.

Print one group, for example: Argentineen,
Colombian, Dominican, Nicaraguan,
Salvadoren, Spaniard, and so on.)-

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Yes, other Spanish/Hispanic

(Print one group, for example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.)

Yes, other Spanish/Hispanic,

print one group.

POR CENSUS USE

Measuring America

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11. At any time since February 1, 1990, has this person attended regular school or college? Include only nursery school, kindergarten, elementary school, and schooling which leads to a high school diploma or a college degree.

O No, has not attended since February 1

O Yes, public school, public college

O Yes, private school, private college

12. How much school has this person COMPLETED?

Fill ONE circle for the highest level COMPLETED or

degree RECEIVED. If currently enrolled, mark the level

of previous grade attended or highest degree received.

O No school completed

O Nursery school

O Kindergarten

1st, 2nd, 3rd, or 4th grade

5th, 6th, 7th, or 8th grade

O 9th grade

O 10th grade

O 11th grade

O 12th grade, NO DIPLOMA

O HIGH SCHOOL GRADUATE - high school DIPLOMA or the equivalent (For example: GED)

O Some college but no degree

O Associate degree in college - Occupational program
O Associate degree in college - Academic program
O Bachelor's degree (For example: BA, AB, BS)
O Master's degree (For example: MA, MS, MEng.
MED, MSW, MBA)

O Professional school degree (For example: MD,

DDS, DVM, LLB, JD)

O Doctorate degree

(For example: PhD, EdD)

13. What is this person's ancestry or ethnic origin? (See instruction guide for further information.)

(For example: German, Italian, Afro-Amer., Croatian,
Cape Verdean, Dominican, Ecuadoran, Haltian, Cajun,
French Canadian, Jamaican, Korean, Lebanese, Mexican,
Nigerian, Irish, Polish, Slovak, Taiwanese, Thai,
Ukrainian, etc.)

14a. Did this person live in this house or apartment 5 years ago (on April 1, 1985)?

O Born after April 1, 1985- Go to questions for
the next person
O Yes - Skip to 15a

F

O No

b. Where did this person live 5 years ago (on April 1, 1985)?

(1) Name of U.S. State or foreign country

(If outside U.S., print answer above and skip to 15a.) (2) Name of county in the U.S.7

(3) Name of city or town in the U.S.

7.

(4) Did this person live inside the city

or town limits?

O Yes

O No, lived outside the city/town limits

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PLEASE ANSWER THESE QUESTIONS

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20. How many babies has she ever had, not counting stillbirths? Do not count her stepchildren or children she has adopted. None 1 2 3 4 5 6 7 8 9 10 11 12 or more

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21a. Did this person work at any time LAST WEEK? O Yes - Fill this circle if this person worked full time or part time. (Count part-time work such as delivering papers, or helping without pay

in a family business or farm. Also count active duty in the Armed Forces.)

O No-Fill this circle if this person did not work,

or did only own housework, school work, or volunteer work. - Skip to 25

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b. How many hours did this person work LAST WEEK 5 (at all jobs)? Subtract any time off; add overtime or extra hours worked.

22. At what location did this person work LAST WEEK?

Hours

If this person worked at more than one location, print where he or she worked most last week.

a. Address (Number and street)7

(If the exact address is not known, give a description of

the location such as the building name or the nearest street or intersection.)

b. Name of city, town, or post office

c. Is the work location inside the limits of that city or town? O Yes

d. County 7

e. State

Years

O No, outside

the city/town limits

f. ZIP Code 7

The sample questionnaire also contains population questions 8 to 33, shown here on pages 6 and 7. These questions appear on pairs of facing pages of sample form (ie., 6 and 7, 8 and 9, etc.) for each person in the household, Note that questions 17a to 33 do not apply to persons under 15 years of age.

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28. Industry or Employer

a. For whom did this person work? If now on active duty in the Armed Forces, fill this circle

branch of the Armed Forces.

O and print the

(Name of company, business, or other employer) b. What kind of business or industry was this?Describe the activity at location where employed.

(For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, retail bakery)

c. Is this mainly - Fill ONE circle

O Manufacturing

O Wholesale trade
O Retail trade

29. Occupation

O Other (agriculture,

construction, service, government, etc.)

a. What kind of work was this person doing?7

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(For example: registered nurse, personnel manager,
supervisor of order department, gasoline engine
assembler, cake icer)

b. What were this person's most important activities or duties? 7

(For example: patient care, directing hiring policies,
supervising order clerks, assembling engines,
icing cakes)

30. Was this person Fill ONE circle

O Employee of a PRIVATE FOR PROFIT company or
business or of an individual, for wages, salary, or
commissions

O Employee of a PRIVATE NOT-FOR-PROFIT,
tax-exempt, or charitable organization

O Local GOVERNMENT employee (city, county, etc.)
O State GOVERNMENT employee

O Federal GOVERNMENT employee

O SELF-EMPLOYED in own NOT INCORPORATED business, professional practice, or farm

O SELF-EMPLOYED in own INCORPORATED

business, professional practice, or farm

O Working WITHOUT PAY in family business or farm

31a. Last year (1989), did this person work, even for a few days, at a paid job or in a business or farm? O Yes

O No-Skip to 32

b. How many weeks did this person work in 1989? Count paid vacation, paid sick leave, and military service.

Weeks

c. During the weeks WORKED in 1989, how many hours did this person usually work each week?

32. INCOME IN 1989

Full the "Yes" circle below for each income source received during 1989. Otherwise, fill the "No" circle. If "Yes," enter the total amount received during 1989. For Income received jointly, see instruction guide. If exact amount is not known, please give best estimate. If net income was a loss, write "Loss" above the dollar amount.

Page 7

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Hours

Annual amount - Dollars

Please turn to the next page and answer questions for Person 2 on page 2. If this is the last person listed in question 1a on page 1, go to the back of the form.

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Measuring America

93

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