1991 Census
England


I form for making an individual return

Please complete this form and have it ready for collection on Monday 22nd April.

Completion of the form is compulsory under the Census Act 1920. If you refuse to complete it, or give false information, you may have topay a fine of up to £400.

Your answers will be treated in strict confidence and used only to produce statistics. Names and addresses will not be put into the computer; only the postcode will be entered. The forms will be keptsecurely within my Office and treated as confidential for 100 years.

Anyone using or disclosing Census information improperly will beliable to prosecution.

After completing the form, please sign the declaration on the last page.

Thank you for your co-operation.

P J Wormald
Registrar General

Office of Population Censuses and Surveys
PO Box 100
Fareham PO 16 OAL

Telephone: 0329 844444

To be completed by the Enumerator
Census District

Enumeration District

Form number

Serial number
To be completed by the Manager, Commanding Officer, Chief Resident Officer, or other person in charge of the establishment or vessel.
Name of Establishment

Address



Postcode
To be completed by or for the individual
Please answer question by ticking the appropriate box or boxes where they are provided. Please use ink or ballpoint pen.
1 Name  
  Please write in your name and surname (BLOCK CAPITALS). For a baby who has not yet been given a name, write BABY and the surname.
 
2 Sex  
  Please tick the appropriate box. Male 1
Female 2
3 Date of birth  
  Please write in the day, month and year of birth.
Day Month Year
4 Marital status  
 

On the 21st of April what is your marital status?
If separated but not divorced, please tick 'Married (first marriage)' or 'Re-married' as appropriate.
Please tick one box.

Single (never married) 1
Married (first marriage) 2
Re-married 3
Divorced (decree absolute) 4
Widowed 5
5 Position in establishment  
  Please write in your position in this establishment.
For example, write 'Guest'; 'Patient'; 'Inmate'; 'Staff'; 'Student'; 'Boarder'.
If you are completing the form in a private household, your relationship to the person making the return for
the rest of the household should be stated.
 
6 Whereabouts on night of 21-22 April 1991 Not applicable to this form
7 Usual address  
 

If you usually live here, please tick 'This address'. If not, tick 'Elsewhere' and write in your usual address.

If you are a student or a schoolchild away from home during term time, your home address should be taken as your usual address.

If you live away from home for part of the week, your home address should be taken as your usual address.

This address 1
Elsewhere  

If elsewhere, please write your usual address and postcode below in BLOCK CAPITALS



Postcode

 

8 Term time address of students and schoolchildren

Not a student or schoolchild

This address

1

Elsewhere

If elsewhere, please write the person's usual address and postcode below in BLOCK CAPITALS

 

Postcode

.

.

.

.

.

.

.

.

 

If not a student or schoolchild, please tick first box.

If you are a student or schoolchild and you live here during term time, tick 'This address'.

If you do not live here during term time, tick 'Elsewhere' and write in the current or most recent term time address.

 

9 Usual address one year ago

Same as question 7

1

Different

Child under one

3

If different, please write the person's address and postcode on the 21st April below in BLOCK CAPITALS

 

Postcode

.

.

.

.

.

.

.

.

 

 

If your usual address one year ago (on the 21st April 1990) was the same as your current usual address (given in answer to question 7), please tick 'Same'. If not, tick 'Different' and write in the usual address one year ago.

For a child born since the 21st April 1990, tick the 'Child under one' box.

 

10 Country of birth

England

1

Scotland

2

Wales

3

Northern Ireland

4

Irish Republic

5

Elsewhere

If elsewhere, please write in the present name of the country

 

 

Please tick the appropriate box.

If the 'Elsewhere' box is ticked, please write in the present name of the country in which the birthplace is now situated.

11 Ethnic group

White

0

Black-Caribbean

1

Black-African

2

Black-Other
please describe

Indian

3

Pakistani

4

Bangladeshi

5

Chinese

6

Any other ethnic group
please describe

 

 

Please tick the appropriate box.

If you are descended from more than one ethnic or racial group, please tick the group to which you considers you belong, or tick the 'Any other ethnic group' box and describe your ancestry in the space provided.

12 Long-term illness

 

Yes, I have a health problem which limits activities

1

I have no such health problem

2

 

Do you have any long-term illness, health problem or handicap which limits your daily activities or the work you can do?

Include problems which are due to old age.

Answers to the remaining questions are not required for anyone under 16 years of age (born after 21st April 1975)

13 Whether working, retired, looking after the home etc last week

Which of these were you doing last week?

Please read carfully right through the list and tick all the descriptions that apply.

* Casual or temporary work should be counted at boxes 1,2,3 or 4. also tick boxes 1, 2, 3 or 4 if you had a job last week but were off sick, on holiday, temporarily laid off or on strike.

Boxes 1, 2, 3 and 4 refer to work for pay or profit but not to unpaid work except in a family business.

Working for an employer is part time (box 2) if the hours worked, excluding any overtime and mealbreaks, are usually 30 hours or less per week.

† Includes wanting a job but prevented from looking by holiday or temporary sickness.

$ Do not count training given or paid for by an employer.

* Was working for an employer full time (more than 30 hours per week)

1

* Was working for an employer part time (one hour or more a week)

2

* Was self-employed, employing other people

3

* Was self-employed, not employing other people

4

Was on a government employment or training scheme

5

Was waiting to start a job he/she had already accepted

6

† Was unemployed and looking for a job

7

$ Was at school or in other full time education

8

Was unable to work because of long term sickness or disability

9

Was retired from paid work

10

Was looking after the home or family

11

Other
Please specify

 

 

Please read A below, tick the box that applies and follow the instruction by the box ticked.
This will tell you which questions to answer.

A

Did you have a paid job last week (any of the boxes 1, 2, 3 or 4 ticked at question 13)?

Yes
No
If yes ticked, answer questions 14, 15, 16, 17 and 18 about the main job last week, then go on to question 19.
If no ticked, answer B.

B

Have you had a paid job within the last 10 years?

 

Yes
No
If yes ticked, answer questions 14, 15, and 16 about the most recent job, then go on to question 19.
If no ticked, go on to question 19.

14 Hours worked per week

How many hours per week do or did you usually work in your main job?

Do not count overtime or meal breaks.

Number of hours worked per week

15 Occupation

Please give the full title of your present or last job and describe the main things you do or did in the job.

At a, give the full title by which the job is known, for example: 'packing machinist'; 'poultry processor'; 'jig and tool fitter'' 'supervisor of typists'; 'accounts clerk'' rather than general titles like 'machinist'; 'process worker'; 'supervisor' or 'clerk'. Give rank or grade if you have one.

At b, write down the main things you actually do or did in the job.

Armed Forces- enter 'commissioned officer' or 'other rank' as appropriate at a, and leave b blank.

Civil servants- give grade at a and discipline or specialism, for example: 'electrical engineer'; 'accountant'; 'chemist'; 'administrator' at b.

a Full job title

b Main things done in job

 

 

16 Name and business of employer (if self-employed give the name and nature of business)

At a, please give the name of the employer. Give the trading name if one is used. Do not use abbreviations.

At b, describe clearly what your employer (or yourself if self-employed) makes or does (or did).

Armed Forces - write 'Armed Forces' at a and leave b blank. For a member of the Armed Forces of a country other than the UK -add the name of the country.

Civil Servants - give name of Department at a and write 'Government Department' at b.

Local Government Officers - give name of employing authority at a and department in which employed at b.

a Name of employer

b Description of emplyer's business

 

17 Address of place of work

Please give the full address of your place of work.

If employed on a site for a long period, give the address of the site.

If not working regularly at one place but reporting to a depot or other fixed address, give that address.

If not reporting daily to a fixed address, tick box 1.

If working mainly at home, tick box 2.

Armed Forces - leave blank.

Please write full address and postcode of workplace below in BLOCK CAPITALS

 

Postcode

.

.

.

.

.

.

.

.

No fixed place 1

Mainly at home 2

 

 

18 Daily journey to work

Please tick the appropriate box to show how the longest part, by distance, of your daily journey to work is normally made.

If using different means of transport on different days, show the means used most often.

Car or van includes three-wheeled cars and motor caravans.

British Rail train 1
Underground, tube, metro 2
Bus, minibus or coach (public or private) 3
Motor cycle, scooter, moped 4
Driving a cae or van 5
Passenger in a car or van 6
Pedal cycle 7
On foot 8
Other 9
please specify

Work mainly at home 0

19 Degrees, professional and vocational qualifications

Have you obtained any qualifications after reaching the age of 18 such as:

-degrees, diplomas, HNC, HND,
-nursing qualifications
-teaching qualifications (see * below),
-graduate or corporate membership of professional institutions,
-other professional, educational or vocational qualifications?

Do not count qualifications normally obtained at school such as GCE, CSE, GCSE, SCE and school certificates.

If box 2 is ticked, write in all qualifications even if they are not relevant to your present job or if you are not working.

Please list the qualificaitons in the order in which they were obtained.

* If you have school teaching qualifications, give the full title of the qualifications, such as 'Certificate of Education' and the subject(s) which you are qualified to teach. The subject 'education' should then only be shown if the course had no other subject specialisation.

 

NO- no such qualifications 1
YES- give details 2


1 Title

Subject(s)

Year

Institution

2 Title

Subject(s)

Year

Institution

3 Title

Subject(s)

Year

Institution

4 Title

Subject(s)

Year

Institution

 

Declaration

This form is correctly completed to the best of my knowledge and belief.

Signature Date April 1991