Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698829567480.pdf (Saint Kitts and Nevis)
I I C O N F D E N T A L W H E N C O M P L E T E 50474 SAINT KITTS AND NEVIS ORGANIZATION OF THE EASTERN CARIBBEAN STATES POPULATION AND HOUSING CENSUS 2011 CENSUS DAY - MAY 15th, 2011 For optimum accuracy, please print carefully and completely inside the boxes provided.

Avoid contact with the edges of the box.

The following will serve as an example: IMPORTANT!!!

1) USE ONLY 2B PENCIL.


DO NOT USE A PEN 2) Place an X in the box for multiple choice options 3) ERASE CLEANLY ANY CHANGES YOU MAKE 4) MAKE NO STRAY MARKS ON QUESTIONNAIRES IDENTIFICATION PARISH ED NUMBER HOUSEHOLD NO IMPORTANT!!!
Transfer these codes to the top of EACH individual questionnaire BUILDING NUMBER DWELLING NUMBER VILLAGE NUMBER ADDRESS OF HOUSEHOLD: COMMUNITY: TOWN/VILLAGE: DISTRICT/PARISH: Page 1 of 8 50474 INTERVIEWER SAY: I am the Census Interviewer assigned to this area and I would like to get some information about this household and its members.

Here is my identification card.
(Please show card) INTERVIEWER RECORD OF VISITS Confidential Visit Number Date (DD/MM/YY) Time Started Time Ended Duration (in minutes) *Results 1 2 3 4 / / / / / / / / *RESULTS CODES: 1 = Completed 2 = Partially Completed 3 = Refused 4 = No Suitable respondent at home 5 = No Contact 6= Vacant Statistical Department, Bladen Commercial Development, St. Kitts: Tel: 869-465-2521 and Charlestown, Nevis Tel: 869-469-5521 Confidential Confidential NAME NAME NAME NAME NAME AREA SUPERVISOR FIELD SUPERVISOR INTERVIEWER EDITOR/CODER EDITOR/CODER DATE DATE DATE DATE DATE Confidential Confidential Page 2 of 8 50474 LISTING OF HOUSEHOLD MEMBERS Remember to mark multiple choice boxes like this INTERVIEWER SAY: Please give me the names of all the persons who usually live and share one daily meal with your household Surname First Name Sex Under 5 Years 01 02 03 04 05 06 07 08 09 Confidential Remember to mark multiple choice boxes like this Page 3 of 8 50474 COMMENTS Page 4 of 8 50474 SECTION 1 - MIGRATION 2.
(a) Did any member of this household move to live abroad during the last ten years (2001 - 2011)?

1 Yes (continue) 2 No (go to section 2) (b) How many persons moved?
Remember to mark multiple choice boxes like this (4) (5) (6) (7) (8) (9) (10) Age when moved Occupation when moved Name of Country of Migration Main reason for Migration (3) P e r s o n N u m b e r 01 02 03 04 05 06 Year moved 2001 - 2010 Write year properly inside the boxes provided Sex M = 1 F = 2 Highest education attained when moved 1 None 2 Primary 3 Secondary 4 Tertiary (non-university College) 5 University 6 Other if less than 1, 98 for 99 and over Describe as clearly as possible the person(s) occupation when he/she moved.
Boxes in this column are for official use Write in the space Provided Name of Country Name of Country Name of Country Name of Country Name of Country Name of Country Remember to mark multiple choice boxes like this 1 Higher income 2 Employment 3 Study 4 Medical 5 Marriage 6 Family reasons 7 Crime rate 8 Other Page 5 of 8 50474 Remember to mark multiple choice boxes like this INTERVIEWER SAY: Now I would like to ask a few questions about the dwelling which your household occupies and the facilities that you have.
SECTION 2 - HOUSING INTERVIEWER: Ask this question only if the answer is not obvious.

Else, put X in the appropriate box.

11.

What type of dwelling does this household occupy?

1.

Undivided private house 2.

Part of a private house/attached 3.

Flat, apartment, condominium 4.

Townhouse 5.

Double house/duplex 6.

Combined business and dwelling 7.

Barracks 8.

Other (Specify...................) 12.

Is this dwelling insured?

1.

Yes 2.

No 3.

Don't know 18.


How much Mortgage are you now paying per month?

To nearest dollar , 2 Don't know 3 Not paying $ 19.

What about the land - Is it freehold, leased, or some other type of occupancy?

1.

Owned/freehold 6.

Squatted 2.

Lease-hold 3.

Rented 4.

Rent-free 7.

Share cropping 8.

Other (specify.............) 9.

Don't know 5.

Permission to work land 20.

What is the MAIN material of the outer walls?

1.

Wood 2.

Wood & Brick 7.

Stone 8.

Bricks 3.

Wood & Concrete 9.


Plywood 13.

Are the contents of this dwelling insured?

4.

Wood & Galvanise 10.

Plywood & Concrete 1.

Yes, all 2.

No 3.

Partially 4.

Don't know 14.

Is this dwelling unit owned, rented, or leased by any member of the household?

1.

Owned with mortgage (Go to Q.

18) 2.

Owned without mortgage (Go to Q.

19) 3.

Rented 4.

Rent free 5.

Leased (Go to Q.

16) 6.

Squatted (Go to Q.

19) 7.

Other (specify....................) (Go to Q.

19) 15.
19) 15.

What is the rental/leased period for this dwelling?

1.

Weekly 2.

Fortnightly 3.

Monthly 4.

Quarterly 5.

Half Yearly 6.

Annually 7.

Not Applicable 16.

Is this dwelling rented/leased as fully furnished, semi-furnished or unfurnished?

1.

Fully Furnished 2.

Semi-furnished 3.

Unfurnished 5.

Concrete 11.

Makeshift (specify.................) 6.

Concrete & Blocks 12.

Other (specify.....................) 21.

What is the MAIN material used for roofing?

1.


Sheet metal (zinc, aluminum, galvanise, galvalume) 2.

Shingle (asphalt) 3.

Shingle (wood) 4.

Concrete 5.

Tile 6.

Thatch/makeshift 7.

Other (specify.........................) 22.

In which year/period was this building built?

1.

Before 1980 2.

1980 - 1989 3.

1990 - 1999 4.

2000 - 2006 6.

2008 7.

2009 8.

2010 9.

2011 5.

2007 10.

Don't know 23.

What is your MAIN source of water supply?

1.

Public piped into dwelling 2.


Public piped into yard 3.

Public standpipe 4.

Public well or tank 17.

How much rent are you now paying per month?

To nearest dollar $ , 2 Don't know 3 Not paying (Go to Q.

19) 5.

Private catchment, not piped 6.

Private catchment, piped into dwelling 7.

Other (specify.........................) Remember to mark multiple choice boxes like this Page 6 of 8 50474 Remember to mark multiple choice boxes like this 24.

What is your MAIN source of drinking water?

30.


What is your MAIN method of garbage disposal?

1.

Bottled water 2.

Private catchment, not piped 3.

Private catchment, piped into dwelling 4.

Public piped into yard 5.

Public standpipe 6.

Public piped into dwelling 7.

Other (specify................................) 25.

What type of toilet facility does this household have?

1.

Dumping (land) 2.

Compost 3.

Burning 4.

Dumping/throwing into river/sea/pond 5.

Burying 6.
Burying 6.

Garbage truck/skip/bin - Public 7.

Garbage truck - Private 8.

Other (specify.............................) 1.

W.C. (flush toilet) Link to sewer 2.

W.C. (flush toilet) Linked to septic tank/soak away 31.

How many desktop computers does this household have in use?

3.

Pit latrine 4.

Other (specify............................) 5.

None 26.

What is the MAIN source of lighting for this household?

1.

Electricity - Public 2.

Electricity - Private generator 3.

Gas lantern 4.

Kerosene 5.


Solar 6.

None 7.

Other (specify.......................) 32.

How many laptop computers does this household have in use?

33.

What type of internet connection does this household use?

(SELECT ALL THAT APPLY) 1.

DSL/ASL 2.

Dial up 3.

Cable 4.

Wireless 5.

Cellular wireless/mobile band 6.

No internet connection 27.

What type of fuel does this household use MOST for cooking?

34.

Which of the following does your household have in use?

SELECT ALL THAT APPLY 1.

Biogas 2.


Electricity 3.

Kerosene 4.

LPG (cooking gas) 5.

Solar energy 6.

Wood/charcoal 7.

None 8.

Other (specify........................) 28.

How many rooms does this household occupy: (do not include bathrooms and porches) 29.

How many bedrooms are there in this dwelling unit?

(Bedrooms are rooms mainly used for sleeping and excludes temporary sleeping quarters.
Count all bedrooms including spares not occupied) 1 Solar water heater 11 Cellular phone 2 Electrical water heater 12 Washing machine 3 Television 4 VCR 5 Radio/stereo 6 Refrigerator 7 Freezer 8 Microwave 9 Stove 13 Water pump 14 Air conditioner 15 Generator 16 Dishwasher 17 DVD/MP3 player 18 Clothes Dryer 19 Water tank 10 Landline phone 20 Satellite dish 35.

How many vehicles are kept at home for private use by this household?
(Excluding motor cycles) Remember to mark multiple choice boxes like this Page 7 of 8 50474 Remember to mark multiple choice boxes like this SECTION 3 - CRIME 36.

Has any member of your household been a victim of crime during the last twelve (12) months?

1 Yes 2 No (Go to Section 4) 37.

What was the nature of the crime?


1 Murder 2 Kidnapping 6 Larceny (house breaking) 7 Larceny (auto theft) 3 Wounding by firearm 8 Larceny other 4 Other wounding 9 Burglary 5 Rape/abuse 10 Other (specify...........................) 38.

Did any member of this household die within the past twelve (12) months?

1 Yes 2 No (Go to Section 4) AGE Sex 1 M 2 F 1 M 2 F 1 M 2 F 1 M 2 F Remember to mark multiple choice boxes like this TELEPHONE NUMBER - Page 8 of 8