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-4-
-5-
TO E413+NOVINGMWP
-$
6
(.)
Now 1 would like
tdk
●bout your l.at
.ddr.ss
tit
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ir, u+lo,enuctwu
ADDREis mm
accmc.lation
wad
(b)
hho else
mcl.dmg
AT 9.1
or rented
●t th.
BEIM
MOVINOGiWP 1
(.
HOHOF PSKxws
Hwsmioul
wbydId
&“ud
. . . . . . . . . . . . . . . . d.cMmt98we?
Tim Homo
mm
OD
ii
-w
m
USvcd,
~-,t)
w
PEEziEE
I
7.
1
time you mvd?
lived n wur hcuaehold at the tie
.
....... ?
...............
TICSMOPINGG+WF
RITFB DSTA1lS IN APPRWTIIATXMI
is
fhat
I
;jq:f;fy’:,
~~,
.,”
t.
.—
I
0
I
—
12
I
I
=+=1
12
I
12
12
I
121
I
,$.. .
IIF N@iE TNAN(MZ RCASCPIGIVUI AT 4.7 dSK Q.8
—
,
I
MOVINGCSW7 2
(.*:
,
t)
!
1
d
HCHOF ~ONS
I
HW~III
0
12
I
H
12
I
m
12
I
12
—
12
1
--
I
12
12
1
,
u
—L
-.
A
~V12WS
h&#ehold
, c
=1
-
1s there
●
c.nzinuiw
i
head of
“+
TER ! WIZUIZI AGAINSTHW
0? !WSVIWS HW6EHOI.DIN CXOLJT1
BOX AT C 6
HO14CO$J7
Yes . . .
1
AKKQ. 9+18
No
2
CO TO PRMSNT
Acu&OmN
. . .
Fs-6-
moz
(03M!K!
1 AT Xmmmxml
lU AU OJNTIISIINGNWl,s
9.
How long
so.
did ycu live
OF —
at yaw
last
mEx
14.
Q. A,)
address?
LSTYEAU
ZEUS.
. .. .. .
15.
so . . .
lFLf.WIHASIYSAS~G
10.
Did you O-
it .x
rent
ouud/wa#
Ll@n# .,
Rente+suted
free
LSTOUN
10mGss
11.
WE30ENSn/mls
Did you o=
1
2
1? m
mm fa. u
m70a.12
LS7LO0
ha
(.)
●.
LSTkEASC
it
lemebold?
..... ...................
or freehold?
......................
(.. did Y.m pay eitherf a d.tr
or ground lurden)?
...............
1.
z
mm
‘4. u
16.
3
enfmaca w
fb
Hw many m-ma bmw there
12.
was it
rented
(provided)
furnished
SXCUGIX+
or unfurnished?
fiunished
LSTFURA)
Partly
...... ...
fulnielled
unfurnished
kha did P
(W
was it
retit it
mtided
3
.......
2
LS7REWT
OSGANISATIGNS
kal
AufbOrity
~F=rCYwWV
PraMw
AS
Housing Association
or M.siLm
1
....................... ..
2
or L%aritable
.
3
Scottish
special
.....
4
. .. .. .. . . . . .. .. .. . ... . .. . . .. .. . . .
5
(SP~)
Association
ltust
E8ployer
Other .arstisafion
Musing
did
(I@ I Wt check),
an, of
fbo,e
road
m m
Uzu
m.
.............
...
0
.......
6
. ... .. . .. . .. .. .. . .. . . .. . ... . .. .. . .. .. . .. ..
18.
cuckd),
rn.au
usei
;
.. .. . . .
W R-
let
!
,
or -&let
m
or Smm
Lxr/sm-Im
x
..i
—g
~s7Lm
,.
,
7
mplo,er
.................................
8
m
,
toflet
x
so . .
,,(
.. . .. . .
9
~’
/
sm/sxwm/rim
mm
‘~
NW GO IQ PSZSWl
ooma.18
. . . .. . .
MWHT CWS @lLY AS $4ABX0
.................................
....... ..................
garages,
,. ...
~,,
~~rsu44ic
I?AsYsmms
5L41mmmfSIi
o.SIAnEG-*
JOIQ:IF A RGONIS m/ZG&lX? ~ SA4SSD
Re3atire
Other tiitidual
w
~Pakwoftiem-,
or tie bath (sbcwer) or flush
with another bciweb.ld?
,.
plDmtuALs
NAWJSSASY
2
3
;
Ls7Rootis
6
..........................
&U.pc.ratica
Za..tnrie.,
Latbroms,
entirely
for tusiness.
~’rn.
from?
by?)
New mm
1
1
.,
17.
13.
MK (a)
W IUQ.16
Ofher r-am.
~E
Sssmm
● ~zim?
in year Xast
Utchen (L mom h which y-
PMM?+Mx,
10 21!42S8bm
it
,,.! ,4 ! !, ,
inside JOlr ac~u
la .:
ouzsida yam ●ccomcdat
h!
An8ide tbs tui3dim@
.. ...
.xnSide the bui3ding7 . . . . . . .
INDXVXWAL
PIUMPt m
Cmxmsm
ftur APPLIES
mc
s.
\
it?
:
“
S+th (bhoier)
Flush toilet
kred
,bared
...
.....
\
Ac4WMGATXOli SSCPXGU, PAGS 8
1
z
m m PmmsT
A—TION
SSCTION,
PA~ 8
. . .— .———.
. _——.
——-—.
--
.. . .
J-.
.A..
.
.
.
-..
.
—
——
3’0 AU HCIM2T!OUIS
IF ~v~
~o~
mm ASK cw
HWSEtKU =
1
w..
mm
this
13s.z, 17-19, 25, 25, 274 ZNITHU w
AIM POmTIAL W=
SCC710N
bmldlw
first
1
hilt
befor;
19197 . . . . . . . . .
between 1919 ad 19447
19450rl.
t.fl
..... ..
DK . . . . . . . .
AC
. . EHOUS&
I
m
.
.
.
.
.
.
.
.
..
..
..
..
3
.
.
.
.
2
I
I
1
2
1
m YOU -..
r-
t~~
I
2
. . . . . . . . . . . . . ..7
HOUSE/FUT E7C.
Dins/i.hying
oldtJt40us
I
E
Rents/re.t
free
.......
......
;
1
2
1
-m TW.SC WNINO/BUYIW
3-
~ Y~ .-
OU?JLCASE
it
lasehold?
.........
or freehold?
........
(or do y.. p.? either
c.r g-d
burden)? . .
S
....
....
la
...
... ..... .......
...................
duty
...................
1
2
3
0
1
4.
:
Do you Oul it
%SMNMOAT
outrlghff
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...!
or are yal hying
it on a
..rtga6.
.rl.an?
.........................
MO
(.)
(b)
5
(MY
LTAt+T
NW =ch w.. rcur 2a.t mmtdme.t
on ycur 10U or .ortsage,
including
any endanent
immnce
prehm
aeces mry to .0, er the lmn/mOrtga’e?
NW Lang a period
1 just cbwi.j d. ycw recei
~AT6ReB
●*
(kuwr
U7
R,..
●ea
Ir m
O
a . rate
E
rebate
(h,
w.
a permd does tills
4
Ep
T..
,..
‘2
5
6
As
,U.,, vi
,:’f~
‘
L
S=2cLd.
““” ... ” ”.’ ” ..:: . ”; ”,”,”,”,.:”
““”.”~-.. .”””i”
”:”
.J,@$,g
,
.
~~my,’j
‘. ‘ [
Rdatin
. . . . . . . ..o. .. . .. .. ..%...i.......
.,-,
Employer
‘f
NO
m n-bin
10.
(
do you receive?
1
cover?
(
7
!,,
8
. . . . . . . . . . . . . . ... . . . . . . . . . . . . . . .
-$
ocher 2nd171Au2’
.’. <.”.....
. . . . . . . . ...!
r.k@e7
kcBf17E
Nc- mch
1
mm
). 10
9
.
-
Yei
M. JJTb4>
om
1. 21
;3
.......
*
(a)
long
A!UlN7..
MoaTrln
did this cover?
2
i
RUTIIM mm
Does yuur hmdlomi
3HDxvInms
live
(mDm
in this
/. ANiko@
LYOIEJT-
7-9 AT Q. q)
2ui2d@?
.! ‘.
I
i
!
:
ram ‘..
N. . .
1
2
..
+..
A=
.-i
u:
-...
2
~
i?
8
. . . .-
:0
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*“...
I
1
1
I
1
I
(
1
1
:
1
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g.,
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M’-.
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. .
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:::
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---
~e ‘-
:
-C4m.
!,:
. . .. . . .
.“--,
.”l
I
<<
I
_
:3””:
22
~.,: ...-:. ---.:.. -~-—:;-
7
,..
a?
.p
26.
-i4-
-is;
arm
ALL Nwsl!tmm
Da ya liar. in yam (part of
.Ccomodatioll
*)
foAILuKmlmq
1.
lsmPlmAL.
aw
PROW?
27.
W4TSroRC
electtic
ntgbt
or any other
storage
f.am of
heatnra?
cetmnl
c ● wT+l
Are any of the follcuing
items nomally
available
for .s e in your ac~ation?
-
..
8A~
atd
&
k
cock..
Electric
u.lNC~E
lTPA!S
STLWSD
WI
Usrlsn
S2PAIR
.
.U
.ewrate
ISDIVIWALrridae
PRCUPT
exclud.
Vao.uu cleaner
‘setTvs.t
RLESSR9
.ti
bdMWiMh
-
T
...
. . . .V.~’%%W.tl,
la
../%~9\~..
1
WCARS
Sw-y
Nmmmfa
Sm71cn
Pm 15
(i
ad
0W42124
. .. .. .. .
:
0.%”1t
U
: .““”””iimmi”:
..................”:”””””””””
............. :.
●“”
-e
..
.
... . .. .
. . . . . . . . . wmrtm.+
\
I
wmm
KwmPJm
W32m
?Aw15
.............
1
2
3
“k
c00ds0r13J . . . . . . . . . . . .
B02b . . . . . . . . . . . . . . . . . .
k.ugbl~bcu
mwbuererk’?;
stolen gOOds (ad cdl)
womb b total?
Nil
are there?
&mN
. .. . . .. .
(b)
_
lNCUJDEANY PXOBY wmm
IF N~y
AvA1mw
PO% m W INFWMNT M ~sW
OF
TSS HLW32SOU!. KKCI.W2 VBIIC~
USEDSO~Y
KW TNS u1n
OF @mm
1
Ccms
(d
oom
1Psc8BmAScN8
(i)
.......
,,L,
-
/1
..................................
=
PACE 17
= ~~
K?miac
2
. . . . . . . ~X
Swrms
~
12
so . . .
t~n0ne7
KnUmA2
12
IT km
Or-=
ASK (a)
com
~:.
12
Yes . .
me?
e
,.,
2
1
--4
ius’ihi8b@Awd$
12 Mmtbs?
1
P29
12
1s tbe.ra a car or van n.armallv available
for use by YW or m-krs
of &r
bcus&d?
1. there
Ibunnytkea
during tbe hat
..
No . . .
pm2AafdA1241
i2ilhz+
,
2W
w!
re8
20
N“+M+
,...
.. ... .
12
12
‘~
.....TV......
rented . . . . . . . . . . . . . . . .
Radio/truuistor
(a)
,:,
(.)
lj
deep free%
. ...<..
or ●t2ap2d
#atb347
I?m
.p2m-drie.#Vg~f7
-
(AU.’
A:’ “::,:
‘,,.,
‘
..WS.%W.K...
12
cocker
..
~t!uM329M*
bcm
T3ng bare) h
m7b0d~ got tnta
this . . . . . . . . . . . . . . ..wi2hout
yuir
Nmdrur Bm.
pemiaeim mid stolen
heatin@
Ye# ‘m
2S.
am
EmMH!!c
~:;<’
“(*ll;t)
.............................
~.
lJnder&5 . . . . . . . . .
g5 and u0derf,25 .
u
E25 ■
m
.
t-w.
.
elm
Elm.
~
emo
e2w.
.
am
Llom
●
C9YW
elom andover
...
\
.
.
.
.
.
.
... ..
.....
. .. . .
.....
.....
.....
.....
......
.
.
.
.
.
.
.
.
0
,.
.
.
.
.
.
.
.
.
.....
.....
.. ...
.....
.....
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.....
.....
.
.
.
.
.
.
.
.
I
1
2
3
4
.
.
.
.
.
.
.
.
:
7
8
1
1
1
2
3
—
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. .
-18-
0’
Ccm
m
=
-19-
m
=
7.
5.
Would anyone
else
join
m
wha is not living
ENTIX NO. OF PEiXMT.
1P -
‘=
.here acw?
Why have ycu 4
- ..
......
~“~
Uhat have you done .&t
A%
t~
to fird
Nave YOU ●pplied
stmeuhere
to tkcamcil?
~
IiTO?
mlwLA
...........
rea M
“.
a.,, . . . . . . . . . . . ..dwAdgA
nmnovxsomam
.,
,1::,’
sol
m
~
to x.?
HPuuY
.....
~N;MovE1
., ,: ,:.
6.
1
TO AlLW3U7SWIS
OTOAPRIVAti”~
=,
~ew 1
.,
-,
WJYMDW
;
yiiougz”;i.
12
1;
12
1:
12
1:
...
12
1:
,..
12
1:
.,”::
!
—
AN7N0T
mTILMrAl
NW. p
Cdvertiaed
““”=ti”=-:’:,
or replied
~~~m~cu
M’m(mmT)
!-’%+’”?’;/
to
(.x)
,~:aq!?!ub’
SPC+iTANEWSLY
B
or to rent?
. . . . . . .%lye~fl......,.
....
12
1:
~
1
,-.
m
—
I
IF Wf12iMAN UiEPEASUi OIm
~~ 8.’
ATQ.7
ASKQ.8
. . . . ..*
...
WA . . . mV3
m
or immuiom
SlamUU
, ;,.
z,
:NLWcmxxnAa
PAIR
,,,
m
“’;”’ ;
,
‘ tit.ii
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OW+l
for
~<,?
b
,*
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1
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;
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<!
m OF SwmioulSCN12DUU.
NW Cm
B&X PAGE.
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a
d
s
-2-
-3cow
70 ffK6E WWKDIGMST UEFX (CODED1 AT Q,l~
—
-rLJosoBs
last week dld you have any other paid
Job or b.sueas
u additxcm co the one
you h“.
JU,t told = about?
4
Llll
Yea . .
No
..
1
2
kSK (a)
comas
Y-
.
2
—
ASK (a)
caT0Q7
IF Y=
(a)
OccupatMJn .
.
..
.
Industry
.
.
.
..
.
..
.
OFF, USE
. .
“L
t
mssrlm
PsmFT
11
.
.
.
.. .
111
..
m
e.ploye e .
self-uployed
.
1
2
5
we want to @
a picture
of the
people work . . .11 the Jobs that
tbq
are self--played).
x
extenrhu
m m a.7
5
. .. . ..
●
of tiys . week
they d. (except when
7.
,,
.. .. . ..
<
of my.
I
Pei-..ad
00 KOQ.
over
~
~hOfid be
mllocated
t. the day on
whch ● ost of the hours
were do”.
l!axa
of “o
.. .
4
+?3
8.
Shfts
..,,..
;1
❑ tier
how
(lh.nbang
of ● ll cbe ]ob. you do . . M upl.yee)
many days d. y.. U.U1lY work over a given period?
Include my days wbch you regul.rly
work as overtbe
● nd ● ny days when you work part of the day only,
kin
exclude any days when YW are %. call,, only
h
1,
SkT/SUk_f
......... ...... . . ..
,.
TO AIL EJE’IJ3Y=
IF SEW SHPLOYEDIS AU JOS5, MA . . . . . . .
enry &iT/Sill? .1. . . . . . . .‘. . . . . . . . . . . . . . . . . .
c-V
other
0.0 in 3?. . . . . . . . . . . . . . . . . . . . . . . . . . .
:$=.*
ofteuth
tit?
.. ........
......
(smY’Y)
—
,-.
.
6..
[~
●
!O
In addition
do uIy pdd
to tbi, do y.”
OVertti.?
Ye* . .
No . ..’
USUdlY
1
2
ASK(a)
G+3TOQ9
.. . ..
mma9
1
0
com
Q 10
count re~ai-dl. s a
of hours worked
(a)
h average
-ny
days
worked?
how
over the 1.s= 6 ■onths
● week would you say you
DmYs~
Other (SPECWY)
+
9.
i
......
8
mm
Q.6
. .
.,/14 $
NW lCWUdoe. it U8UllY b
YOU t. ,.t
fr~
hcgc t. work?
~
~~i~’
H ~ !*,*
~
Nrs..; . . . . . ..mn..
........
Wxkat
. ..
.......
N. .aiul place of work . . . .
.
+!
-5-
e
-4ml 33iPlAlm
11.
mm,wumm-w
10.
1
Xm
fmm
Ware you away fnu work at a33 3ast
week because v.. were ill
or had an
accident?
-
12.
46SIJK
Yes...
1
2
AsA(+(.)
s
9.11
falx
I?212FmPfmP8,
Does yourmployer my you
anytNnA wbw you are off
sid17
nJA..
%lckplq~
s
933! 0.13
1
2
3
;.;:;
●Does your taployer
mm . private ~ica
or superunu.tier.
schme for people in pour
kid
of job?
PENslo*;.~;:
EXCf.WE SYAn”C$UBUAYPIDP#WIIX!
AsDmNPsUn PA2mEs7s
x
I
I
,,,, ,..
1
2
3
.
ASK (a)
SSEO.13
IF m
(.)
(a)
kY.u
any Kltimal
In.urance
for last week?
F4d,
SicAm**a Sac+ fit
(i) Did this inclufe or wsre youalso
W
(till t~. include . . w133 y..
my
suPPlmen2ary
(
I
Md this period
llvst week?
of absence
1
2
4
US=N9
[
●
13.
since this prrioi
of absence first
began,
how my
*
days have you ken away
(not o.urtting any in this current week)? —
.,..,.,.:.
,.~~
Ma . . .
.1
2
SYZQ.13
. +
,
Nm s
............
long emagh .
...............
...............
. . . . . . . . .:, . . . .
i.” .. .. ...i . . . .
...
...
...
..
. ..
.. .
DNA . .
%..
.,, ,.,
A= (c)
.
SFX Q.13
wufxiiYK3scu9rti
.
...
Insurance cc+m-itution
ycur behalf?
Iwr~c*”
rat. for
“ - ---~
.-
lUOMffIW
w cmtritution
m
;.
Q.11
w
ma.14
Z
paid
mll m contribution
:“-”:.
‘S*cia3
Sate . . . . . . .
,,
‘.:DK . . . . . . . . . . . . . . . . .
~*a;)
.. . .. .
mm (i)
ASK (ii)
~.
Sotoldemqh
.. ......
Mot been with the fim
T.mold
.............
,T-wraryj
ebm3y . . .
sot Intel-e ate r. . . . . .
Dth.r rez,sma f-~)
w w WY t~.fill
~:
. cmt ribt ion or the s cid
marric.i w-co
(widows ?
I
(c)
1
2
PWwtlAoi
msAsRmDAnDuxrAwm
~,&$@EDIATQ.l
J
.
1
2
so . . .
(ii) WY are yai not h the sc~?
.
,.
4 ,.. . . L... .+ ,.
(i)
,, cOntributio.7
1
2
end
Yes..,
No...,
,en
,,
., ..:,
re . . .
...
(b)
1? m
1? w
Yea..,
No...
also be @d)
allowance 7
PFWSYOU
to the scheme.
belons
....,,.,’
● ●
Pai’2, c.rti33Ymb
w
,!
.$$
+
~
....
....
.....
. . . ..
ASK (a)
mm
O.14
.
~
Yes . .
No . . .
AW. (i)
w mQ.14
IF m
(i)
IF IN mm
OIPE 3?ASY Am nsrtw
DATES ~
AVSRMS KMKTW2 tWS SACH
b’uK
I
r
1s tMs the fuil Nati.~
“iikiurkce
contribution
or the special
rate
for married women (widcws)?
Ml
NY contribution
....
Special Nate . . . . . . . . . . . .
M ......................
GO TUO.14
I
-7-
-6-
CODE
. ‘M ALL FJ@fAWKSYAI&ISEWWIANED
If.m long have yself-employed
(i.
14
bee. with
your WI.
ycur present
Job)?
15
mployer/
L-ssm chmn 6 months .
6 ■onths b% less than 1 year
1 vear
tut 1.s.
N
(a)-(d)
Save Yca refaincd
any wn.i.n
rights
frm my (other)
pre.ious
job which
YW .r. either drw%ns ncu or will
●ble to dr- in the future?
ExLum
NM W
than 2 years
1
2
s7Afs mAwAlm
Pnslws
S67! PAYWEN7S
W70Q.15
10” years
m Ye.r.
(a)
than 20 rear.
HW many chmge. of =P1.ye.
tive
PI ude in the last 12 ■onths7~
IF NO PRSVIWS wUIf?WJT
mm
,0,,
(b)
tut less
or .Ore
HW dxd you ~
W“ 11 through
30
16
W IAS.? 12 ifWfH5,
hear .bcut
your present
which of the .tatwenU
. . this cud ca.s
.e.rem t, on the whole, to what YW cM*
abcut ycur pre.ent
(ui.)
job?
7oBsfiT
3.b -
_ Upl.Fent
exc~f?a
H ‘AR
. private
empl.~ent
aLencY7
an ti.wusme”tq
.
. relat.v.
or frmti?
.
d,r.ct
appl~catlon
t. M employer?
or ,“ some other W,T7 (SFZS21PY)
RWMIW
PSCIHPT
BUT
CODE
0ss
ONLY
HANZIINYfWUWf UQDA
EC H AA)
1
2
3
4
:-:
1.,
-.
I
:
.
Are p
leavitu
(c)
D.d you have . period without
before you routnl your pre.ent
Na . . .
..
(STAYS CAKNDAS, 4 WTXLY STC)
scheme rm
●t
+.
m-
.
mcwm
d,d you rece,ve
a refund
. . . c.ntr, but. on>
--’
,,3 Qlenhmc
(Mb. FtnsT.
“J
,Asr
(i)
1::::s
<oh
&t)
transfer
y-r
penmm rights t. ywr
pr . . ..t
].b7
d.d y.. ret...
MY pension r.6hts
.Imsh y.. me ether
draw.~
nw
or ..11 be able to draw m the
~u~re,
X TO
fm Sw
PACE 14
UAVE2
by
pre,laus
2
x
all
e.plopent
w (d
mm SEA
J 31
PAOS 13
y
1
PREv PE?JS
Yes
No
No prev.o.s
mnmtum
~
1’
Dxd not lod
1
Ifm
I
ha,
IT m
(I)
when ym left ycur
e.ploye r dld YOU
41
job)?
I
%=
to . Fnalon
e.plOy.r’
~ ,,.
CD m (d)
~OBLOObf
Dld YCUbelow
y...
pr.v.0.s
,,
mr.cusly
thi*ing
of ‘-’
your present e.ployer
(%f+plqed
1s= (i)
1
2
~
IF m
(1)
turlw
that peried wi thaw w.*,
h.m 10IIS were
YOU~
look~u
for W*
before YOU f~~
your pre...t
lob’
(d)
. . . dissatisfied
work
.
Job?
70BUWCHP
Wonths
very sat,sfid
Fairly satl.fied
Neither satisfied
Rather dismtisflcd
<
. +i~ Very dims. tiafled
4
—
z—
1’
1
1
Of YOUZ
1
sow co m
‘Q 15
NW SSSQ
31 PAGE13
—-------
..
.. .. . . ... . . . . . .
..
..-. -...—... .-..-.-—-
.. . ..
.,
-.. .
-8-
T0TH3SE_m~UMKfAST=
18.
X..,..
lkuing
-9-
(mom4ATQ.1~
To Au
rakf m PU were lookdng fc.r turk bst
the seven &y8 endinA la8t SUIAY
‘=’*‘““’(YO.th~lopent
‘h‘b ‘“‘“ Wfice?
-’rwere you on the books of a private
@
weak.
21.
Fm)wf
did
you tie
‘“’--
2
33 TO Q.SO
......
2
haf/lfPw
.........
2
UK49Vg&
............. .....
-P1OYMIW
agencJ7
were you awaiting
did ,0”
or NP17 to ●d?erti.ements?
a direct
aPPTOaCb m a p199vCtiVe
employer?
......
2
....
2
TO ffnd work?
(SPSCIPY) . . . . . . . . . . . . . . . .
2
rbe mmlts
do aqthinA
else
of
3%5 At Q.1)
(-
WlmI did PU h.t
work?
t/fAwPE)(
lNDIPIU.WL
did you adrertise
uwAw3ama
j .ab applications?
mtwf
As
NP2msAsY
< , ,,
fass thm s wok WI . . . . . . . . . . . .
he week but less fbm 1 mntb . .
1 month bt less fban 3 maths . .
3 mntiu but legs thm 6 mntba .
6mntb#
but lena flun lyear
...
he year ormm.
ag., . . . . . . . . . . . .
00 TO Q.22
.,
22.
SW Ai6 you Sfop W*?
23.
km you rerainad h
p&wiOn J@ita
fm. a pmvAms job ticb
P. are
either dnwiq
now m will be able
to dr.v in the f .UIre?
S5
Q.31
pm
13
~<
.......................................................
.......................................................
TO TISSE WAIT1ffi TO STAST
19.
A SW JOB (03M
~ AT ~ol~
rat
week were you or. the kooks of an Ihplopeat
Rciunse
(Youth EBPloymmt Office)?
Yes . . .
....
:
6P4?LOY;Y
‘?:
●
20.
Oid YOU &,”,
Ur.C+lojnnt
OF benefit
o
EWXAIDEsTATECRAIUAT~ _IOm
AIIDYAIUPWIMHS
,,, ,,>
.
,.
..’”;:,..
.,.,
,., .,,,
,,,
IV” (IIWW, any
for bat week?
ASK (a)
00 TO Q.21
Yes . . .
m ...
(
●
uwta-lPtlEfu
mm
(a)
%$
Did k.
inclwde or were you .ISO
paid (Uill this include or ti13 you
also he paid) any SUPPkW.tary
allowance?
/
‘f
Yea . ,
m ,.
1
2
GCl‘TO Q.21
“’’””+’
(e*;t]
Yes . .
m ...
.!! .:./
,.. ,
. .
i.: .-j
1
2
,SES Q.31
PM 13
_____—
_ . .._..
—
. . .. .
.. —-
-.
.—.
. ..
. .
.. .
.
.—..
-----
24
Last week
ul~
Lb” C“’’’’”ca
~
werey.. EPIPLOYED
ww co SChO.1 .r =Uese
2s
Have y..
.....
..
.. .
mar done any paid work?
,
IY Yks
(a) MI.. did you fimmh pm
1
.
‘;
TD M
.
*-RUOW
“:
1
2
fiat
Job were You doing when YOU stopped
3 AT Q.M1
REYINSO (03DEYI
26.
I
*
‘K(b>(d)o’o
;
(i).
/tit
!
-Ocalration
‘“
YOtU usudjob?
..: . . . . . ..!..
..... ....
1
2
ISK (b)-(d)
Industry
work?
cm.
m.
.1s
. ..’....
Y.8 . . .
NO . . I
.@&*”
{r
............
.
,
.
.
.
w
vAatnaLts
3,
Q-
.
.
L
.
.
(~) &LL
? ~.
*Y
tid
YOU at.P
Ou?
111
rr
.
.
r
.
‘e’”p
c
m , .,
......... ... ... .
IF 70 DR 0~,
●
~
MA .
.
.
..
.
.
. ..
1
2
.
;SS Q.27
.3.
25.rkam
l-u
.
Nil
)gp.
:,
DR mD~
2 AT Q StS,INA
Y.*
.
,=.
.-
fE.
Did You dnw, or will you drw,
benefit
for 3ast .eek7
.
.
. ..
.
,
am
LEISURE
PffiE 14
M m Q.28
w m Q.29
. .
;’
“0 “
Yes .
[:,;
;;:
ASK (.)
CD m Q.29
L
EIMUCIWPB=
(.)
1,
,)
1
IJrm
,
any tmt@.yment
wmk7
Pre~.uwy/to
atu-t a fully
’...
:.
To get -rrmd/chan,ye
of dc..e. tic
rmpm.ibihtiea
111 h,alth/accadent
. .
.
Retmed - PRCtlEwhezher volunmy
or c09pul SOry
Redundancy/Job f itmshcd
Dther (SPECIPY)
...
I
EZEMPCX
.....
..... .
. .
.
1
4,
.:, .
‘?’
uat week were ym on tbe kooks of ‘m ~loment
sx~e
(Y.utb hpl.apmt
Dfficm )7
. ....
;ss Q.27
,SK (,)
. . . . . {h”
...... ...... .... .. ..
..... .....
,,
@*
1 ‘
2,
.... ......
70 Y7iC6ERETIRED. IMPmG IKWSE. m mma SLVmYmNOmm ‘MST
69 Y3Y.NSm mmm
H
(CMDE713-5 AT Q.24). ~Dm
m 5mLmm
NOT NASACM MC.,
::t:~O&:t
11
IP
+
suPmmnfJuJmT,
fl
PROBE
Four
....
~loyee
.. .
,df
enployed
IF NkN.4m,
(c)
.
UITI(
cOmalwcB
W-6
....
i’
;
....
1
Industry
EE Q.27
fJ
>......
e@Oyee
.
. . .. . . . .
...
elf.
employed with employees . . .
self - ~loyed
without ~loyees
.
us
x
R6?7/R~.D
.........................
..
EE Q.%
1(
You tdd m what job YOU.me doinc
wb.n y.” ,topped work, wa8 tbt
tha
job you did for MM of your .orkin#
MY.?
\&a
1
2,
II
mA . . .
-,
O.-pat
‘ET
Ye. . . .
Ho . .
i
be yew tat leas thin 5 years
?ive” y....
but le..
than 10 Y.U.
●’. . . . . . . . .
Ten year, ormr.
)
P6?JS
Am
I
.% (a)-(d)
M! Q. 27
Job?
h you cm.ider
yourself t. b. a seasonal
Ye.
worker - that IS someone who re~ona
No
to work put of tbe year 001Y7
n-
I
+
&
PDMIm9
●
4
300
i)
(b)
.
w..
JMI retied
MY Ptrdom rIgbt8 fprcdaii
job W*
YOU .~~er
.,.
dr~ti
m till
be able to draw in tbe future?
mwrs
amn
mMUAm
fmw m
PAYlm17s
k..
cbn Imnth
as.
....
. . .
on. .onth hit 1.s. than b months .
Six month. but 1.s. than 1 YCU . .
L4SY
(ew;t
%
lmt
(d)
P I
..
~
mDE
mm
(NA ~ ~ m
)
permanently unable to work? .
. . ... . ..
. .
.
. .
rctlred 7
keeping h.”,.q
.
. .. ... . .
or were YOU dmng s.meibiq
else? (SPECFf)
.
1
-11-
-10TO TRf6& mDm
fdd this inclwfe or wem you *1.. ptid
(will this include or will y.. .1..
be
pud) My 8uPPk9entU7
dlcu-CC7
.
~ ;
‘
{
1
.
Yes .
No .
~
1
2
u’
S0 m Q.29
I
I
I
I
I
{
!
t
,
I
I
i
I
1
t
1
)
1
E
8“
““
“’
;~l
-e+
;
i
::
.e4
::.
~
,4:
.:n’i
::
::
::
.:
E
-.
:..
.,
c
~,
2
t ~
. .
~“?”
.-
.. . .- —. —.:
,::
:?
::
.:: ..- 5.:
d
-. .
,, ,.,...,,
“’:<.,,
. .-
. ... ....,
..
..
-,
,.,
-:
~
.
.,
.i
“:!
1!
E!
e
--
..,- —— .. . .
—.-.
..-—
-.
(
-14-
)
IT7ED
aU
. ..—.
——
.
.
-15-
,Whjngw
I!Z!E&a
lea
NO
1
2
.
.
(a)A(b)
mmaz
AS
IF Y7LS
(a)
*ere
mDE ALL
XTIATAFPLY
dXd y..
lx
8. for
your Idid.y?
. . ...
mAlu.d (excl
1.1. .f lb)
Scotxalld
..
. .
.. .
waXe.
.. .. .....
. ..
...
. .
I Northern Xreland . . . . . . . . .
Atrmd (Xncl
Isle of Man,
. . .....
QuMel
1.1.s,
Sire)
.-,.
●
Lstenirq
to recOdS/WWO
ON
Y
xl
1
2
Y
xi
1
2
I
I
2
xl
1
2
Oing out for =al
(not in
..... . ...... ..
tiorkinc hours)
Y
xi
1
2
OIIIS out for a drink (..t
XII
“Orkxns hmuw) . . . . . . . . . . . . . . . .
r
x!
1
2
x
~
1
,
2
z
. .x
,
~
,x
,
x
x
thers
(SFiXXFY)
..
....... .... . ...
..
. ..
.
.... ... ....
....
...
.
. . . . . . . . . . . . . . . . . . . . ........
.
... . .......
. ....
.. . .
..
.,.
..
...
...
. .. . ..
...
.. .. .. . . . .
..
. ...
.... ..
..... ........ ..
,,
,
,
!4
2
1
4
2
1
4
2
I
z
4
2
1
,
z
4
2
1
1
2
4
2
!
2
1
x
1
2
x
1
2
4
2
1
x
1
2
4
2
1
x
1
2
4
2
1
x
1
2
4
2
1
r
J
L
PFU3~ ~
5UR ACTUALACTIVXTX AND_SD
RmC Y XN 031 OPmSITS
IT OR
(c)
(b)
(Apart fro. those you have ahedy
menmmed) IMm
You done my of the act,vitma
lMted on th.i. card
m the 4 weeks ending last Eumhy?
ssmRD DSTAILS DR mm
-1XF
IAl ACT1VXT1C5
(.)
Md
w
.i&tiH.
vhiXe . . h.XidaY.j
other tue,
.r ●t s-e
UUUW XABt Sundey?
mDE mCS A~VXTY
x xs mx Opmslm
or both,
,
in the 4 weeks
,- .
mNE IN mXJfM (C) (1)
KTR LUSI ACTXVXTfuPIDa lHR
(SPLf2XPX)1 SXCWT . .
TSXXE mm ONLYON mxmw
ABmAD
MSNTXONM, SRIG
—]
9?9
s&m#kTxml
(c)
;,
1.
,
‘,
~!
I
mNE, fNiL-x
your holiday Xi+ [A&AD])!m
liw MY
kn the 4 weeks ending Xmt Smd.y7
days did you .Itititi
m 5 ormre
days . . . . . . . . . . . . 5
‘a, less ofmn than tlmt~ (PmBE)
(4 days . . .
T.{2 or 3 days
.lhG ‘liE APPR3PRL.-;
.... .
. . . 4
......
..
2
1
. .. ..
IO~Y one dv
‘h
CCDL IN mX (c)
(IL)
,
mi~ 2 IN
mm (c)(,) mR
uu+ AcTIVXTy
mNE mm SEE
(C) (11)
!
!
(i.) (APrt 1-
MINTS
AS NmXS*SY
Ds’F
USE
mw
4
. . . . . . . . . . . . . . . .—
.... . . ..
... ....
....
. . . . . . . . . . . .. ..
.
. . . .. .. .. .. .
...
. .-
. . . . ...
. ....
mu
Os-fss
mLxDAr
ASiOAfI UK
-r
......
I
Hot
(aw:vfc-
&ctiTixy
dme
..............
muxmr
Y
L
U. are Sneer’emt=d in the thin.ss peqde do m ;heir
lexmr.
tim - wbrn fhey are not -*in&,
at school
or ..11.s.,
or lc+km& after the house and f mily
Can you tell . . At
mart of things ~
ham done
m Y...
sPare the Sn the 4 week. mdmg lam Smd.y?
Ds
(ii)
1
L#itSn& or .Ymerxaiuiw
fri=xa /
faly
............. ......... .
(w+ w)
(a)
rdlq
.Cxl
........... .........
ta radio
WrMAQ
OR m
P, h?rclPm 0,
S-ATM
2
1
Lint+
..
‘E
(.)
Alms mm
DBCSXFTKW OF A~~fl
l,d 1*.
yea to think abut
the 4 wcks emllns lut
WV.
luring these 4 weeks did YOU stay .-Y
fro= h-a for one
night or lower
on g
kmd .1 hol,day?
1
..
(c) (i)
(a),(b)
mm
~
.. .
J
AGAINSTm
A~vTTY
1
I
J
ISEE
EUJCATIW
WE 16
—.—— ._ _______. .._ ___
. . .._ .. ____
,____
.._ -
.
_.-+-,..- ______
-!7-
-16-
w
— ----
WX30ATXDN
0
) ‘xNGSlfw
mm
mm )13X7XONEG.aAssE9
(.)
m X.wwm
Ar. Y.ni at presentattendh4
my sort
classes
CUIWIY for recreatirnt.
durim
x
he
yw
1
2
&’.:
at pmscnt
.ttendin.z
full-tire?
PRGNPT
( including
rem,timal
.. ..........................
2
m m 4.3
L rscowsed
trade
.......................
‘3
s Cdyin’
or preparing m your oan exuination
0. qmlificati.m?
5
APPLIS5
for
......
(b)
vixbin
6
t.
tber.ext6mambs?
bt 1.3*S thul
-“*,
m-more
DO yuu expect
vacation W*
1
WNNXNO
PSDMPT
bk.n do YCU think
this
- Sea30r S.c&&y’
(L%
““”
. ..........................
LlnIlt [fzG7xAm - Grant-ded]
mbool . .
,,
Im3epm3at
mhool (#g YubXic SI%WO1‘ti “ “‘‘r’
B@ar@laxes,
plivate
school)
...............
Spedaxdlonl
(for
bO@taX
Sclmbl
Au16ic+ped,
school & c)
(sPmIFf)
Imf,
—?=
[XCC4L AOfiDRIT!
. . . . . . . . . . . . . . . . . . . ...!..
.
,. ..,.,,
begin?
within fhemxt
6-tbs?
.....
6 mnfhs tut 1.8s tb.m I year
‘from
...?
....................
or more xhan 1 year fr09 now? .
AIRUXIXhGPKING . . . . . . . . . . . . . . .
Co<&t
. . . . . ..~
.........
.........
.........
8
9
!E2
1.8. .
8
9
(, :
11
13 ‘
$
13.
,.
IMtitnta@ollege
of Aduxt Sdu.XtAm
(Tem-lmr Trait@g
. . . . . . . . ... . . . ... . . ,., :i..
1
2
3
MO GXYE I&M)
L..,..,..,
;
....
J“;
.............
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...!...
1
2
(i)
n m Q.3
~, s
00IXe@)
. . . . . . . . . . . . . . . . . . . . . . . . ...”..’...’./..
COlxege (SPWXXY mm
[6 ,
;
..
[A,
rea .
No . .
7
7
,,
Giliremit,
or
will
school]
s&OOl]
education
W ~
(i)
~—
[=
selmtive)
selective)
C0X3ege of ~tim
6
..... ..................
‘ear
fnow?
xa do my IW-t-tiM
before tben7
Oucvflc
6
z=mins
I AT
.........
than 1 year fr091m .,7 . . . . . . . . . . . . . . . . . . .
.-.
6
other
ycur YuX1-tbe
wT[N2
L%8pMmuim
mlmol (incxudfrlg 5A
&“
“’
College)
.....................................
00 m Q.4
PAM 18
~>wIL~J@
crnplete
nJ.OE
—
!.
NON%OF XNESB (INGIAIDSSANWXW/_
-8
SlGDRit2 AT UIRK NOW) . . . . . . . . .
Da Y.. cx~ct
)DE
5
other
4
Ft13&T3fW (03~
_
IDE
—
5
4-year
rmedial,
i-eceivitI.s any other fom of education
such as by c.rrespmdence,
private
tutor, et. ? . . . . . . . . . . . . . . . . . . . . . . . . . . .
0 lfULSE ATYLXDINGA ~LhJIZ.EXXi
.lJbJ
19
.,* ‘.:, ,-
~Oimct
m 3GQ.2
F1S2’Y
WA?
.
..............
(3..
SBE %8 w
00 T0Q.4
PAW 18
..-.
&_+&,+_
54.
1(b)
1
IF NSX~,
Arm YOU xakins
.pprmti..,bip?
mfm mc
SGNmfw
PrC4fPT
SS
a .Ck%?::ol%u
. . .. .. .. .. . .. . . .. .. .. .. . .. .
0P part-the
classes)?
Am
—----
1(b)
OR UNX!UI
1NLYIV3
WAL
(a)
S5
of
the
r
1
(b)
—
sm7xLM
‘“Y
“’G*“-””-’M”
6UC-FWC
TGIW2.9BAGS049
--
,
., i
AXfGtADYNEITIONEG, DNA . . . . .
.
-. . .. . -
-”
Is
;
i;
16
17
18;
18 ;
W,
m,
mm
Q.4
____
. .. -.--—
.—4—.
. .
..
.
--
..—. . —————
.
.
..
-—
-18-
ODE
3DE
what type of mlmol or co31eSe
Xaw ●ttend f.lX-ti-e7
did P
.GW<4
‘*W
0’ “-lntemediate/Sisber
‘-’
‘h””
Cm’’%mrd)
Gmde/A12-aSe/ViXk&e
3
....
t
3
b
secondary POdem [SmTL4fM - Junior secondary
(3.r
4-year selective)
school]
...... .. ...... ....
5
,5
bpr=hemive
46
I
) . . ...1
6
Gramar [s03~D
- sem.r
second-y
(6 year
select.ve)
=chool] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
D.rect
8
8
9
9
10
10
#chml
G-t
(2ncl.
[SMTWM
Stih
Yom collog.
- Grmt-aided]
mhool
.
...
school
[NDT ‘xUSrNfCAL mI.L$G?.] . . . . . . . . . . . .
Special
school (for Imndicappti,
fsn,
hospital
mhml &c) [WML AU~MTY]
Scbrnl..cside
riacdsal,
.............
UK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ocher school
....
~.
12
,
12
not yet
$
. i.
13
}.
&
.
*.
11
11
13
(SPECXFY) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
of Educat.m
m lK
.
or umvers.ty
outside
Un*verslty
cmllqe
(Teacher
Other college
m K
How 03d ..=
M
Mich
17
. .
ym. hem you left
Qs
S-7(b)
grawam
l–
20
..
I
1
I Niddle
i
I
I
b
~T1&I
/sAvT ATTXllGm m
TW3SE AT’TmDXlS3
lDSD 16-20 AT Q 3 OR Q 41
ATHDi
/
(a)
(b)
H..
of ~
old we-
bhcb
tem
did w.
2m
(
you when you
attend
eft
tlut
full-the?
(.)
w
DAX
[DNA m AssED AWDyl
)S3
SS% Q.8
~
~~
—
.elect,ve)l
Gmot
‘ i-
... .
.
x
x
---
,1
x
x
x
1
1
1
2
2
2
2
2
‘3
3
3
3
3
/.
~..
junior)
.
...
...
-,JhOr
,cl..tive)
Sixth
h-
. . I
3
3
3
3
3
,
4
4
4
4
, ~;
1 . . . . . 1’5
College)
. ..
. .. .
5
5
5
5
6
6
6
6
7
7
7
7
7
CL8i
8
8
8
8
9
9
9
9
I -6}
... .
[S03TUND - Grmtaided]
Lwher(Spsc,m)
+
d~d you leave?
Uhen IS your b.rtbday?
H
,.. .
- San.. S.amdarY
[SMTWM
I
school?
1NTN31WCE
.
..
..
... .
. .
...
. .. .. . . .
. ... .
=,
. ‘ .
“1 7
, .$
..
II
~1 13J4
*I>.
. . . . . . . . . . . . . . . . . . .. .
..
..
,!
....~.
... ,
&
special
m%1001 (for WiaP*,
reudinl,
hospital
mhool etc)
[LDCALAUXWSXTXI . .
.... .
y
‘- - k2 ‘;J;J
Uhat tme
(mcl
.
, ,,7
Independent (e& hibxic !lchml m Ehw/
wales, primt.
XhcOl)
...... .....
. .
[lNCL. PSIVATENGR5mY, PREP , ON
i+
‘
SP~L
-m]
x
—
/
..
. ..
modem [~~
(3 or 4-year
“-
G-r
(d-year
T
When is your birxhdayq
. .},. . .
.. t
..:
n
Veq
Orcup
. . .. .. .. .. . .
c-prehensive
“’:~v%f==
1
school
seconds..ondcm
Direct
UIISS mms~
. ....
pmtofa MmiwSchml
II
fnfants,
&SmrY (include
[WL
AUTWSXTX]
d
ther.d
school
Gay fl.r.my/Play
!
HOMLSCH “/!42
II IASLSCH
- -g
bJIFMcH
... ..
. .. .
LT~PE
ASK
19
ASD GIVE NAM2) .
.
.
term did(xtm
lNT~wCE
(c)
,..
.
,
(b)
m W
18
(SPECIFf TYPE
..
Callege)
..
.
(a)
Timning
COL
acmtd
nur.ery school [-L
AUNRfTx 1
nm. pi-t of . P*I’Y
school,.
I
College
,IL5
ON M
7
‘*
Independent school (eg Fublic School in s@nnd/
. .. ....... . . ..... . .....
wales , private .Chool)
Te.+umcal
A.% Q.5
Tlmi s=
Q.8
.
.
~!
...
t
11
11
11
11
13
13
13
13
—
a
n.. .08
,, “.
,, .,,,
f
f
mR TS+DSEAT SC303L (CODSD1-13
(b)
When M
Is birf~7Hpfiv
NN SEE Q 9
HTH
I
i.
a
-2
+
E
L-–
.
.
::
::
::
:.
::
::
::
:.
::
::
::
.
r-
.
.
.
-—
—
.——
-——
..—
..
..
. ...—
-23,.
-32-
,
Cms
MDZ
~
1
x
1. what country
we=
wuBo&N
you born?
,
.
1
2
. .
tiglmd
.
Sc.atlmd
. .
wale s
N. Ireland
,
.
tit,id.
m (GIVE mism
. .. ..
..
..
HM
.
.
. .
.
..
.... .
....
m mmmr)
.. .. .
.
.
.
.
mm
-
:.
z
Q.A
Ass h)
‘~
.
t “. “:
,
Inium-y
.... . . .
.::,::’
..
W
LWTSIDEUS (03DS0 Z AT Q.11
(.)
h
1
~ .-
.,
uWS
Ill’,”.
- 1. Inforuntts
IF Yfs GNs PmYal
IF NO Rmo-x
f.ther
e+loyee
.
self- mpl.yd
. elf- “played
t.
. .. .
3
In what country
born?
TO WIMM fHLY
.....
MOO
Ass Qs. 2&3
k
would y..
usual job?
. . . your father
describe
Oc.amation
.
. . Pll
. . BoRy
ODTD
ClfBX Q.B
,
,
,
,
I
‘
DHA1
f),
fiat wad pm
WOllmng life,
—
Your fatbarts
~
Imsbud,.
~
ocmpatic.n
for
‘
x
W’m
HsALffi
PAGE24
Y
co m (.)
most of hi!
~,$
-
?ASEq
.
w. ‘m
Hcu’m
PACE ’34
;
3
with mplovees
wi th..t
employee.
@o””
m the
6
2.
.,
Aa&\oguH
ti WhAt Ytid YOU~
in the Mimed Smgdo=?
lN~~~
household
.:;!
.
w
IF
SSSQ6
‘
“ ‘.””ud’”c-pa’i”n
I
.2
..’,
P19$c~/l&s
Idumtv
Industry
.
.
. ..
.
.
.
.
.
.
.
.
.
.
e@. ye.
.
.
self - employed with -ployees
..
se3f - .apl.ay.d without employ. es
B.
lNIEiVI~
h.us.h.ld
(3WJX- IS infcruntt
a ..tber
m YEi cm
i.
~
.
,,,
,,
. .
mployee
self- espl.yed
self- mployul
1
2
3
*
;
3
ti th aployee.
without wpl.yeea
the
.
Pmscw No.
.
d
IPNORING+1MQ4
4
1“ .kt
country
bm-nv .
..s
your mother
. .
. . . Mf160AN
.
.
Ird”stl-y
.!
)
Sm Q.5
employee
.. ‘
s.1 f– arpl. ycd with m.ployees
.,; f . . ..loyed
w,thw. t e.ployees
1
2
3
A
CJ3m
HSALnf
ME 24
-2s
w“
M- (G;hc(
yJ$ql’-”
,-&
-
?+
1.
w,
bsve j..
hmimg the seven day. ending 7esterdaX
listed
on this card?
;
“
IN~~
=
the hcwehcdd
Indigestion
.. —,—.-
i?cJ&
,.
-die.
..:................................ 1
z
Dthm painkillers
...................................... 3
Cald or cnngestionmlievers
........................... 4
Cough tixfures
......................................... 5
Vitti
pills
................... ....................... 6
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
wwmwntmmmm,
imw~
FDN
mm
CATECDNY
IN Wx BmOu.
(.)
TAKm
s
x
-
W., tbe brand -?
AND
(d-(d)
2? NDT KNWN
:,-,
my .Nldmn
96in
umler
,.
,.. e,...
b yw (or ‘iaj of jiar
lonsLstmdiIu
i13nesa,
child.
dia.bi
uder ‘*6) liiii
or Imfimitw
{
‘..
..........
.
No
cuao#J
dND mm
,.
‘h
I*1 (2nr0rmnt)
(rnfomant)...........
Yes (&ychi2d)
02TA219
..........
~.(ti,-}:;::...,.
I
tit
1? m
(.)
Ulut is the utter
wit;”
mom m
mu DXYNIS ~
*j*
x
‘1
2
!,,
‘ \.
~ ‘:
1
2
19s (a)-(c)
n
mQ.3
lm
26
1(.)-(.)
CN
JINK SCNEDULE
xl m Q.3
(child)?
DINO cm
●
ic
AEK (b)-(d).
o“ a do:tirii
pmaRiPtiwl?
have y.. taken . . . . dw~
CNLY, dSK (d)
FDN WJ.RE/PIU@OWDENS
(d)
NW WY . . . . . tablets/pills/powders
eroding ye,temiay7
Are them
,,,
was in itY (RI=
-YE
LxssEDDNEx37.@.
FNCtlE~ANY
OYNEllMANtifYFSC#TNIE
Cd_
TAKRi MKLISCSEtHMYE
mDINO YFS~Y,
ANDmm
DETAILS ON SE&4SA7S LINE.
What
YtxI E4CZ4MJND/lYFE T(b)
Did YOUget it
(.)
Kc+ many times
, ,
tbe semn
have you take.
(b)
ATDXRY
D. RJT~
‘RE-COD=
lNGED AT
!. 1
,
-
mmia.2mos25;
ASX 13UE3TIME
.,
]6 in thawehdd
. .. . . .. . . . . . . . .
so cbi3dmnuwler
YesNzin codes ringed on this Scbdure
. . . . . ...<.
Naia CQ&Saringed on another schedule . . . . . . .
‘,. ‘.
taken my of the sorts of
●.dicims
..plr.”
.:
CODE
~
NANDMFIMNMTCASOM
-
Uu.c
I
days eding
during
yesterday?
the .qe”
(c)
days
. .j
(d)
I
m.
BMND NANE/
Cmmz’,
G
USI
was
.ttle
seen;
m$
w
mcmil,s
FllmulIPTIDl
YES
ND
(b)
......... ......................
12
1
2
ad
9phint
3rd
mp2aint
, ,, ,,, :WZ.YCS, . . . . . . . . .
1
1
No . . . . . . . . . .
2
2
let
m
. .. .. . .. .. .. . .. . .. . .. .. .. . .
tlMS (CUO?i ‘~
(Cbildis)
activities
) tit
ymlr
dn my way?
.-. ______
.
(
. . . .. . . . . .. .. . . .. . .. .... .. . . . ..
......... .....................
1’2
12
1
1
2
2
............ ...............
............ ...............
1? m
(i)WI. dif(alom
mlm.ulm ) first
to 3idt
ymw (tildt
a) mtirities?
24SS fima 6 DOOW w
......... ..
6 mafba iut leas tbm I year aflfi,
1 year hlt less tbul 2 YWtr# ago .
:Yearaht
ly
than :Years
ago
..”.
0
+
......... ..... ................
12
1
2
. .. .. ... . .. . .. . .. . . ... .. . ..
5
12
1
2
.. .. . .. .. .. . . .. . .. .. . .. .. ..
(ii)
......... .....................
12
1
.. . .. .. . .. . ..
2
*
“’9
.Ioe
.
...
..
...
...
...
...
...
.. .
...
...
.
.
.
.
.
.
.
.
.
.
...
...
...
...
...
...........
ormm
. ...........................
370HB2ST
N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,..,,,,..
,.,.
]0
......... .....................
*w.””-
yeara
20 M cc+mider tbnt (CW?13 mN&AlliT)
MmIts ymir (CMMI S) activities
cmpm-e.i
most people of your (child, s ) own age?
with
Yes . . . . . .
No . . . . . . .
... .... ..
NWMIU
(c)
PAGE 26
Cti~~l~lr
;1
2
1
2
I
I
1
!
,.
&----y
. _—
.-.
-.—. — -
,
‘s
.:. .
.—----
.
4 2
.
.
.,
.._
‘1
_-<.
~
i:ii:-
. .
_—-—— .. . . . .
::
01
.
<
25”
—..
.—.
--.
,..
4.
Lliring the 2 weeks emiing lut
“&ay,
apart frm visits
to ●
hospital,
did YM (m any of yam children under 16) talk to .
doctor for my reason at dl?
/
Yes
~
:a%Lr,
1
*
(d
& (b)
:,~~~~:~ti?”””””””
...............““ : :a;:
No (All
children)
........... ..
,..
IF
(a)
.
2
mm
30
(f)
(b)
PME 30
00 ?0 9.5
,(U
~
m
M)occklfir“.
SW .UIy times did y.ni (or ymr .Mldren)
to him in these two weeks? P*
talk
Info-t
LASK (c)-(g)
(c)
,0
b.
scu
housetmld
outside
L .%~k
................ .
,,1
-
4
k.’
8..
#!3,1
i
~
,“
J-/
Cal@me?
.tyalr.
RvNsfsQ
2
PRCMPT
inb L,
. .;(0
........
lam week? . . . . . .
............ ......
....,.
ltae?
. . . . . . . .. . . . .
Wrg*Fyf
~.).
..fi,
.. +:...
.F. ..< . . ..<.4.1q.4..
(SPECIFY)?
,,,
,..
.
.
.
.
2
.
q.....
3
d
. . . . . . . . .. . . . . . . .
~~
$W? ~i
,0.
-
hcusebold
. . . . . . . . . . . . . . . . . . .. H*.’*.
@
E
16 or me
4
m m 4,5
PAGE30
Was tNs consultation
or the weeA before?
kid.
,,.
k.
b,
(c
lom~d
(c)
otlmr
-“1”)
‘
.........................................
1
......
N .~
,,.
or w
elsewberc
-“
Other ■ember of
.%me..e
-
UMciali.tY..WJ.W.Y?;,+JS.’
2!
‘CA
j
16 in household
w
tM .
~
?d
mm.
—
this
........................
Child mder
or wu
m
Cmc
h wh-ase behalf “.S
.masultatim
made?
..
susfinm
c:y
0“
(b)
MU this camultation
utder tha
““”
Naticrd
Sealth Semi..?
. . . . . . . . . . . . .,.u,,~:~;~:;
or paid for privately
. . . . . .?”~; ..:.’...
...
,,..
,,.
,,, ..’
,..f,~,,{,
uu tbd doctor,w
,,”. ,.o. ...*.o#cr {,
t W ( ic fmily
doctor)?
,ti%w.,+~+.in
(d
‘ (I--7
(Infomht) . . . . . . . . . . . . .
cmE
~.
,+)
m
I
.
●
~
2
,,
I
x“
(d)
CODE
ALLnAAT’
APPLY
cm,”,,.
,0.
Whit W.. the cms”ltatim
●i.mifl
PSOSS FCR FULL DSTA1f9 lNCfllDINO CAUSS
S_
illness/dis.bility
u Q. 2 . . . . . . .
●
Q. 3 . . . . . . . . .
Same ill.ess/injury
Other (SPSCIPY) . . . . . . . . . . . . . . . . . . . . . .
n“
-
,.,,.
,,\
; ,-”,,
~, ;,...
..
..!.6;
“(,
1
2
3
,W,
;.,..—.
,,
.. ..,,..
.,*.
is . . icum
mwtimw
pmt of ● group fnaetiC8~= ~ ~
d
Smauws
it is houstd in a
Was the surge~
Sm3th titre.
you (child)
went to, in . Nea3th
Centre?
...
,,.
., ..,+,... ,
,,
.;.?.
f YOs .,+. .
,,..,
.,., ,,, , No ,.., . .
!,l
x
... . . .
,:ri,r
W,
,,
:,..,.
(i) SOmtiws . surgery
IF tTS GIP% NAPZ.”ANOAfImSSS
.
.
. .. . .. . .. .. .. .. . ..
.. . . . .. .. . .. .. .. .
f
+
:’””
$’
g
(.
1
2“
d-
.-
5x--
““
●
●
,
l-l
+
&f’
*
●
.._—
Qd
I&
L
*O
‘J
7C3’
—
—
—
.
.
.
.
.
I
I
i-is
—. ..,-
‘“
1
.—
N
cm”
-3z
-33!
%%
. . . . . . ~Y=
~m
tk -ths
of . . . . . . . . . . .
(or w 03 por
m. c.ut+atitnt
de~t
under 16) ●ttend M a patient the aaudff
hospitil
(a~t
from ante or wst-nmal
dinka)?
,
ChudNn
‘;
of
i
.
30SBNSI
hid
m“th was this?
How many the,
did YOU (child)
attend
in that
tjn ‘“
%%%
..
aNldl&)
..
. ...:.
‘mlW3nmTSUnrn&T
-
1
k“
~
(2M3d) seen ● doaor in -t
out-patieats deparfmcat before+ ●bout t6i9””
~~t.c.=will~the~~~~g
(,)
~i
r=
(a)
(b)
no (all
or are you waiting
?
.::::::fl
cr”’l
( nlfolunt)
“O(nlfofunt,
Xu
,, ,
m
.1
YC+I(or of your -drea
mder 16) he
an ap~fnt=ent
depar-t
for an appointment to sw ● doctor ~ m mt-mtier.ts
Yes (AaIy child
.
.. . .. .
-
‘*
7.
.—.
month?
8(a) ON
.
w&nL
L
& lo Q.9
ASK (i)-(ii)
SWI before . . . . . . . . . . . .
pti,t
,*
.............
oPrlasT
u
(s) nmth~
(b)
No. of
tins
Imlmta I
c)prn~l
is Oince ycu (CbLld)
cold that an w.poimfaerit nadd
be -de
for YOU (child )1
(i) Ii.m lms it
uerc
OPFJOI
oPhJo3
~
.....
I
..... .
OPMAIT b,. tbml
OMW* .............
:,c::2,3
:,,, -l-ad
“::’ m ‘our r W* aOkk) ti’&
;;.-j
!
,.!
cms
(c)
~-~
,
Oid YOU (child)
make this (all of f.bece)
ric.it(s)
as a Sstioml
Health patient
..............
or were mm
-de
IF COl%2
-
(i)
11,
IFnss?mts
.s
a primt.
wtient?
...
“oPpRW
Hw WY
make as
●
of these
priv.te
tiaits
did y..
patient?
/,
00 m 9.8
2
=
,,
(i)
.*,
appaintint
sad. following
. spell
...%.
.s M in-patient?
.,.
. ,~....*
‘
,,,
“ ““”(JM”I+)
y’0 . .......”..”..........
.....................
-
(child)
-.
f
-:.:.:
T
,.+,:C
j..
no. m v19-
I
,..
,
.......
00 m 4.8
.
...
.
,.,
,,
. . . . . . . . .I
h
,’.
,,
f ,,,”
~
9.
Am pi (or w
of your children
mier 16) at present on a;
~ W&J%lMnt)
waiting list for *SS108
to hospital
a an in#.(&~t),
i,’
pttie.t
(apart f t-am ●
straight f.mu.f
maternity
! .,
bm&iW)?
..,,
I PAPPT
k-.::
NO
I? m”’
n
(a)
EXQSIDE
VOLUNTARY
WAITING
I’m
I
.,,
‘;
now
low”’ba,e
.
lW, ; I‘m
,.
children)
,-
k
1
.1.:
.....
than one week
*pleted
weeks ~
(d
.,&%?’Rr34
Ssfmn 9(.)
ON
,, ? ; \
I
..
1
+
--l
2
PISS Sclimulx
M m S~lNO
=1ON
PACE 3d
you (Chiti)”’bdon
tbe
waiting list
(that is how long is it since
would have t.
the d.ctor said you (child)
go into hospital
when a bed was available)?
,p~~l~ss
?0
a.9
-+-i.
(
*, :<, ,,. .:\
(All,
...
3(.;:.
4
.-.
. . . . . . . . . . . . . . . .
0.
}
NOWCO 2’0
SMOKINGSECTION
PAGE u
!
..-
‘“
I
0
-.
:
.I’4
0 ---------.
--+.
-.
—
.“
1:
0.
!3
—.—.
0
—
d*
=
..
!--’---s.-65
. .. . ..
——
Qb
d
u
:
i
-26-
Cls”
‘o
lATQ. ~
7UALLWiG SAVS~SMXSG(01GSAl
10.
YCWmake cdzus
~
of w
kind
1:r“
1:
Ail
(a)
SW*’ ran Ov*r m-l,
aw
Yes
.....
‘“
1
b ......
m
WI
(.)
mmdmmuamu mmormzmmmm
-20
A6cut b
Mint vu
‘ “!
[m2a1ATa,
@’, i.”
c2Gd2snlx12s
Do not 9A.
‘“
2
2.
At th9 2AM of yau pr”ent
muri.’.hcu S911#
c621drm did ym tk2cAt rou wwt.d i. ●ll?
meditm .0
dzu2-.t
k’.
;:..+’
m
“1!
-k’ b’..:$$;:,
. . . . . ..
1 . . . . . . . . . . . . . . . . . . . . .. L. . . . . . . . . .
,,.
N.. mnked Am. month
‘wm 13.12’
.,’
tbm
Le.,
,/0
ml 2WT
?h-h”ky%
usually E02.
.* A:”&
●
It
. . . . . . . . . . . . . . .,
do you
week
About bcu man, m2ni.zuMcl@r,
nok, in ● 90ntb7
b,.
60 ,OU usudl,
mzr.iat”lu
~c’u%.~
..
..
I :
.. .
/1
S2S
1N7mvIKim
iO
LxsmssLLQ
................
Sm
da YOU
‘omit)
.
gi.enb
Was inforntio.
W .df -cowletiom?
●
IF18mmm,
.
., . . ..! . . . . . . . . .
qoestiw+ng
mA,
-W-Pi-i-
elwo pm...%
duriq
zbi.
. ..
Ml
RAMII.Y
mmmA71Lll
ME 3?
..
)s
(.)
yn
.: .!
-
,.”
V
ZUW,
PL4A.?4 S18G —x:
rzsdszdm
,>,
rmbwzrnwdnm
(e+)
,?(!.
,..’~
MOZknr. ..t . . . . . . . . . . . . .
mtlnr
rem
m
awlrvriwrmwsws
. . . . . . . . ... . . . . . .
.. .... ... ... ... ..
D@tkmcu
.........
B
Sm old .erw ~
6,
h
,,
8~PwA2E
u-
a5
2—
PLS6SS
AWA!SR
Q. 8
3+
PLEASE
42SWR
a 6
ti
ticdwl ;!
rocntlaw*-
w
had YUIr last CUM?
~ “ill
- J??*:bnl 06
yal
.
9
.
Mhat wu tba ate of birth am+ sex of ●ll
h-n .li,.
to ycu i“ ,our pre.ent ,u’riw.?
Q.7
. . . . . . . . . . . .. H0UPLM.%9A#SlKR
b“
w, F~tiki4:T.!!.
1a, t
+6#aa#$d
~A9
7b
*
!“
cb22drca
n
IAA<
DAIS w
U-M*
Ssx
I Pm mm
mm
-1~
l.t
ch21d
WW.b!Wl
M
child
FAA414n%
. . . . . . . . . .AM&
.. ..
M child
Fw!?!!$.
“TH’:
r~rn$f~l
Iv
. .W!Y?.
. .. ... ... ... .... .
. ... ... .. .. ... ... ... ... .
1
-.:...
-,44
Fit4VAl
r
1
. <$s.
tlAaAk~
w ●#48fA
.. . . . . . . . .
mm AIL *< Glder .ibl@,
.. .
?lMT APPLX G2bm elder rdmir.
rmln:y;blly
;:::::::
N(1H .SKltFA,I,,,Y ,NF’””},lT, ON ,,KE ,,
.
,
FAHLAST1
5.
I
;,
SS2 m2LLLl
Imm2L4mul
n107’
RN
FflHmluw
....... .....
9ec.2ier.1
~
1.s
(a)
1
J<’
or
aw8stimin2
.......
SMEVF??
~
UVCU
;,
,~,c’;:
(.)
.
Sss
b.
b,:
XaGn. PLrAs2 RmG —---
! , ‘~ ,>
tbul 1 . . . . ... . . . . . . . . . . . . . . . . . . . . . . . .
20. _kedaueek
B.
; ‘“’ F4MbJAtJ7
...... .....
. . . . . . . . . . . . . . .,
lb. _ked
in a wntd ~
1F4c22sms
Is Amsm
(a) About hcw =MY miniatwm ciw’a
.s-11,
de
a week?
A.
MfiEMTM
Mmm . . . . . . . . . . .
~
. “.*?
No. nokad
GQmot d.
-h-,?
dndhmnny
cMldrmdoyc.u~th2*
YOMw211
lm.. born t. YOU2n a21 h yaw pr..cat _rrAaA.?
,1
nmm.
::
of ,CW PNsant
~~, ..! ...*
mu,, mediu, or LUS. CIWS do’yca
90ke in a month? ~cf~~~*M
usually
12.
tlw d,t,
:,
1.
‘“E
mcm12niT
11.
m
=
12
m
:’ o~qclq~k+-:~’w!,:::”:,,
‘[“
,1, ,.
ti
nIuci44a+ti**d-k,,,.,,.,1,“b
,
mwy@H
i~dtye~t
..rms.
......
●ll MII.dAY.?
●t
CIGRR
,1
,!
.—
..liL
..”--,-
FfIrnSEkll
tg
—.-.
——L
.——
—
I
-—
--—-—
a
.
———_——
.
“
I
●
J
23
.
:=
,,1
t-
31’
mos
v 3NDSS ImxfYmD
IR W3D3WS P~SIDN
,.
1s pm
10.
NAY30NAL3Nsm2Aws Mmsmssf
(d) Ar Q. 1)
Auorftm,
(SC4MICE
pansion
paid
mA . . . . . . . . . . .
,..,.
m
●
thr.wgh
1.
POsr office
a knk
. .. ..
.........
–2
I
,.
MM ~
PAID 3fKNIH
IflK
MS?
would you pref e, w ban your pension
payable into a bank account?
D?FICE
lmQ.7
)m
ir.
(4)
for
1
2
....
3
lmQ.8
X (a)
) m 4.:8
.mm
(i)
●
this?
,;
23.
!,
.. f,,
,,w..,.
,::
h.
13ked
for
SOmOWle
YOU l-t
tlv
d2d P
collect
&“:
.:. (,:
i.!
f:, ~j
it
yoursi2fi
COzhcted
,
~.
;
i
Ye* . . . . . . . . . . . . . . . . .
No . . . . . . . . . . . . . . . . . .
2
—
j
1
2
3
h.’
--e+dd
ham c021ecfu3 it .
mdlaue
t0ca120c.t
it . . . . . . . . . . . . . . . . . .
.. .. . .. . .. . . ... . .. . . .. .. ... . . .. . .
(SSCIFY)
dlich
L20w&eki
i.,
‘ah
Cud
tu Wllect
you? Ptmim
Onrr tyou bA?l.02 to aim tile E4CA of. *
‘“*
to
time?
!“, ~zie,!
,You A
*
weakly order.
~,
Yom
~
CA&.”’”.
““ ,
,/
YI*C;.
i
1
would you pi%fer m have your Pensim made
payable at the cud of each mnth,
thmt i,
=0.tb2y in arrears,
ins-ad
of each week
as at present?
2
Yes . . . . . . . . . . . . . . . . .
1
no . . . . . . . . . . . . . . . . . .
2
3
NO d2ff erence{flf
IF2R90NNOD~
(a)
!buld it
fait
:,..,< 2
S/m
you better
,,,
NUSNmO
PmWT
....
to k
paid
!L
...’:’:
four weekly? . . . . . . . . . . . . . . . . . . ...<
Cazmdar mmbly?. . . . .. . . . . .
......
no diffemme7..
,
or wuld it tie
‘“
...
.V.ry
1
.,,’
●
‘1
2
B
lmQ.9
1
2
3
—
—
...,
lmQ.9
mma.
lz
*-’I
you prefer your pinion
to be paid at the
office
only 0...
every tm weeAs instead of
week as at
As (1)
mm
Q.12
, :,
.,
Post
.
-
.>,
ti.ld
~ (a)
F, (b)
it (a)
AS (a)
h.% (b)
72
IF w)
(b)
Are there ally sPccia2 masons *Y fm wmld “
not prefer u he paid m.mtb2y in arrears?
1.
2CU
pmuh
-It
some
Other
,..
170Q.8
i.
U0u2d
your
,aE 43
—
SPS.izlreasons
,
t3m Q.11
m (a)
IYm
ams
made
No difference/hi
ew
.:.
.“.
Yes . . . . . . . . . . . . . . . . .
them
,.,
(CDDSD 1 A? Q. 6)
No..................
IF ND
(a)
tie
2
m yw
fhraugb
ftl PENSION~S
1
IWEm
ia Pm
x
—
Present?
Yes . . . . . . . . . . . . . . . .
No . . . . . . . . . . . . . . . . . .
NO difference/fS
....
IYfNlm
Q.22
(b)
would YOU13ke t.
I?DQ.1O
have 0..7
. ..
Yes . . . . . . . . . . .
No . . . . . . . . . . . .
1
2
mm
Q. 12
. .
P44E
01%17r~D
~
.
13DE
12
If
hat
you needed mf orutmn
do y..
thh
atuu t dramng
YOU muld
your
to fmd
do -
pension
out ~~ut
mm-amC+ux
‘t
1s ‘ms 3NmmlAnT
Look m pens...
took
Ask at Post Off Ice
Ask at S.x.al
Sec.rlcy
Ask relat.ves/fr.cr.da
CODEoNE ONLY
other
1
mme13
:
A.% (a)
2
Of f,..
.
.
(sFECm)
.
.
.
(i
look
~
m
U3km
PAOE 10)
,,
IS
TNE 3sYURUST
_
,.
..
‘.
No . .
70 OR OVU (W);
= ~.?_
(MMA3X)?
65 OR On
coma]]
As
(i)
. .
c
Ask at
Socm3
inok
●
Office
.
Ask relatzves/frlcr.is
other (SmmY)
IF 03DSD 2-5
(a)
HaY 11..<
che notes
check,
do YOU think
m your P..SMII
hook,
(z)
m m Q.14
:
AS
WXKING,
15.
pmm..era
b
ati31
2
—
fN3
my y.”
took?
p=~l;
&
. . . . ... . . . . . . . . .
14
@
●
it
is
me
it is .c.
of ,Yh.
Feason.
,“
372EY
(a) Is it
the
nin
any paid W*
TO TKLSE UXU3310
16.
ycu fmd
m helpful If the pens...
ore
reformation,
e~ther stout penamr.s,
anythms C1SC7
Benef Its, c., ablt
Yes
No
Never
w.
w.
IF YXS
(a)
!$,alar$
took c.ntamti
or other Staze
1
. ..
thou~ht
about
2
IC
3
AS. (m)
m m lNT
Ilmx
PAOE 43
of
Infer.ama.
do you dunk
.t
sho”id
ra
IT
CH2CI
x
Ty
1
2
.
W-ts
do with it
r.....
dms t do
or not?
why y..
at presmt,
~
?.
*
Yes . .
No
....
(mDED 1 AT 3MFUllfmt Q
1
2
—
m m Q.14
Wa”ld
.
wrk
Y.*,
No,
1
llU
my ham tho uoum
of
emwus
are above ● certdn
1* this w.. of the . ..s..s
*Y
YOU do., t do: my
ammult
p-d
umk at ptmment or i. M n.tbfms
t. d. -Cb
it?c
SM.
‘*.
1=
14
;EE Q. 15
low Sss
Mm PACL
their pummn rcducd if ttheir
(a)
or not?
1S there any partm”lu
r....”
would” Bt look m your p.m...
2
—
om
:HEIX C
;EE Q 15
k’
1s ‘nm mmmfIXT BEE3V3W SIPP~TASY
BFNWIT
(YES AT INmME Q 5)7
at
Ye.
N.
IF
1
B
5
you wauld look
2
1
2
1
2
security
.
DW SSE BKX
ACE
om
HEIX B
—
Ask at Post Off Ice
PJ3t4fONE ONLY
1
Yes. .
N.’-. . . .
I
I
reason why y..
P.s...
book?
Pasmn
..
1,
If you waned to bnov s... dung bout
.aflmr State
~
that mght be avulable,
&t
do you think
to fmd
out abut
,c?
YOU would do ~
Look m
.
..
mmq13
13
Q
5
IPm
1s there any particular
would., t look m your
UIAEt
PmlANF313T-i
mDED 2 AT ~KD~mT
at
Yes
No
(i)
e
Yea
B
fF CODm 2-5
(a)
hY 1 JUSt check, do YOU think YOU wuld
the notes m your pens...
book, or not?
DDE
1)
&
>
S0.. pmsimers
Am still
W* UY have die ammt of
fhar
pe.aim
roiuced if them eaminLm me abve ●
upon
bes
this xule have my effect
certain amount
the wc
of W* YCU do, or has it no effect?
...
t
Yea, mom effect
.
.
.
No, no effect
1
.
2
Im SEE
PWX PAGE
..
~
-—
..-,
..
-.
mm
,.
“.
7.
.,
,>
,.,..
.—
,.
,..
,.
-..
.-.,..
.,
,.
>: .,
~ i,
. .
-
-.