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1911 Census--Canada
Province ____________________________________________
District No.________________________________
RESIDENCE AND PERSONAL DESCRIPTION
Place of habitaName of each person in
Relationshipto
tion. Township or
family, household or instiSex head of family
parish, city, town
tution
or household
or village.
Family,
household
or institution
Dwelling
home
VISITATIONORDER#
S. District No.________________________________ Enumeration District ________________________
In_______________________________{ City, town village, township or parish)
CITIZENSHIP, NATIONALITY AND RELIGION
Single,
Year of
Year of
Country or provmarried, Month
Age at ince of birth. (If immigration naturalizaYearof
Racial or
widowed,
last in Canada, speci- to Canada if tion if fordivorcedor & day birth
tribal origin.
fy
province
or
an
immibirthday
merly an
legally of birth
territory.)
grant.
alien.
separated.
Nationality
Religion
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Cost of
education in
1910 for
person
over 15
yrs.
INFIRMITIES
Blind
Deaf or dumb
Crasy or Lunatic
DeafandDumbNOTto
beentered
Idiotic or Silly
(Numbers given
for above categories)
Can write
Language commonly spoken
Can read
EDUC. AND LANGUAGE OF
EACH PERSON 5 YRS. OF AGE
AND OVER
Months at
school in 1910
Cost of insurance
in census year.
Against accident
or sickness
Rate of
earnings
per hour
when
employed
by the
hour
Upon life
Total earnings in
1910 from other
than chief occupation or trade, if
any.
Total earnings in
1910 from chief
occupation or trade.
Hours of working
time per week at other
occupation, if any.
State where person
Weeks
is employed, such
employed
as "on farm", in
in 1910 at
"woolen mill", "at chief occufoundry shop", "in
pation or
drug store", etc.
trade.
INSURANCE
HELD AT DATE
Hours of working
time per week at
chief occupation.
WAGE-EARNERS
W’ks employed in
1910 at other than
chief occup’n. or
trade, if any.
Employment
other than at
Chief occupation
chief occupaor trade
tion or trade if
any.
Employer
Employee
Working on own
account
PROFESSION, OCCUPATION, TRADE OR
MEANS OF LIVING
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15