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Census 2006 - 2A (Short Form)

Part 1 – 2006 Census Questions

STEP A

CONFIDENTIAL WHEN COMPLETED

2.

Print your telephone number:

 

 

 

 

 

 

 

Area code

_______

Telephone number

______________

 

 

 

 

 

 

 

3.

Complete this section if there is no printed address in the address space above or if you lived at a different address on May 16, 2006.

 

 

 

No. and street or lot and concession

 

Apt. No.

 

 

 

 

 

_________________________________

 

______________

 

 

 

 

 

City, municipality, town, village, Indian reserve

 

Province / territory

 

 

 

 

 

_________________________________

 

______________

 

 

 

 

 

Postal code

 

 

 

 

 

 

 

_______   _______

 

 

1.  WHOM TO INCLUDE IN STEP B

  • EVERYONE WHO USUALLY LIVES HERE, AT THIS ADDRESS, including newborn babies and room-mates;

  • STUDENTS who return to live with their parents during the year should be included at their parents' address, even if they live elsewhere while attending school or working at a summer job;

  • CHILDREN IN JOINT CUSTODY who live here most of the time. Children who spend equal time with each parent should be included in the home of the parent where they are staying on May 16, 2006;

  • SPOUSES OR COMMON-LAW PARTNERS WHO LIVE ELSEWHERE while working or studying, but who return here periodically;

  • LANDED IMMIGRANTS who usually live at this address;

  • Persons claiming REFUGEE STATUS and family members living here with them;

  • PERSONS FROM ANOTHER COUNTRY WITH A WORK OR STUDY PERMIT and family members living here with them;

  • PERSONS who usually live here but are now IN AN INSTITUTION (such as a home for the aged, a hospital or a prison), IF THEY HAVE BEEN THERE LESS THAN SIX MONTHS;

  • PERSONS staying here on May 16, 2006, WHO HAVE NO USUAL HOME ELSEWHERE.

2.  DO NOT INCLUDE IN STEP B

  • Persons who have their usual home at another address in Canada and who are staying here temporarily (for example, persons visiting or persons who have their secondary residence here, at this address);

  • Residents of another country visiting Canada (for example, on a business trip or on vacation);

  • Government representatives of another country and their family members.

3.

IF THERE IS NO ONE TO INCLUDE IN STEP B

 

circle

line, three arrows pointing right

 

If all persons staying at this address on May 16, 2006, usually live elsewhere in Canada or are visitors or government representatives of another country, mark this circle.

Please print your name and your usual telephone number below. Do not complete this questionnaire. Mail it in the enclosed postage-paid envelope.

 

Family Name                 Given Name

________________________________________________

Area code

Telephone number

______

______________

STEP B

1.

Including yourself, how many persons usually live here, at this address, as of May 16, 2006? Include all persons who usually live here, even if they are temporarily away.

 

 

 

 

______

 

 

 

 

2.

Including yourself, list below, using CAPITAL LETTERS, all persons who usually live here. Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children who usually live here. Continue with all other persons who usually live here.

     

 

 

FAMILY NAME

GIVEN NAME

 

 

 

 

 

Person 1

__________________________________________

 

 

 

 

Person 2

__________________________________________

 

 

 

 

Person 3

__________________________________________

 

 

 

 

Person 4

__________________________________________

 

 

 

 

Person 5

__________________________________________

 

 

 

 

Person 6

__________________________________________

 

 

 

 

Person 7

__________________________________________

 

 

 

 

Person 8

__________________________________________

 

 

 

 

Person 9

__________________________________________

 

 

 

 

Person 10

__________________________________________

 

 

 

 

STEP C

Did you leave anyone out of Step B because you were not sure the person should be listed?

 

 

 

For example:

  • a person living at this address who has another home;

  • a person temporarily away.

 

 

 

 

 

 

circle

No

 

 

 

 

 

 

circle

Yes

arrow pointing right

Specify the name, the relationship and the reason.

 

 

 

 

 

 

Name(s)

 

______________________________

 

 

 

 

 

 

 

 

 

______________________________

 

 

 

 

Relationship / Reason

______________________________

 

 

 

 

 

______________________________

 

 

 


STEP D

1.

Is anyone listed in Step B a farm operator who produces at least one agricultural product intended for sale? (crops, livestock, milk, poultry, eggs, greenhouse or nursery products, Christmas trees, sod, honey, bees, maple syrup products, furs, etc.)

 

 

 

 

 

 

circle

No

arrow pointing right

Go to Step E

 

 

 

 

 

 

circle

Yes

 

 

 

 

 

 

 

2.

Does this farm operator make the day-to-day management decisions related to the farm?

 

 

 

 

 

 

circle

No

 

 

 

 

 

 

 

 

circle

Yes

 

 

STEP E

Copy the names in Step B to Question 1, on top of page 4.
Keep the same order.

1.

NAME

 

 

 

 

 

 

In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person.

 

 

 

 

 

 

PERSON 1

 

 

 

 

 

 

 

 

Family Name

 

 

 

 

 

 

 

 

______________________________

 

 

 

 

 

 

 

 

Given Name

 

 

 

 

 

 

 

 

 

______________________________

 

 

 

 

 

 

 

 

2.

SEX

 

 

 

 

 

 

circle

Male

 

 

 

 

 

 

 

 

circle

Female

 

 

 

 

 

 

 

3.

DATE OF BIRTH

 

 

 

 

 

 

 

Day

Month

Year

 

 

 

 

 

 

Example :

  1  3  

  0  2  

  1  9  5  0  

 

 

 

 

 

 

If exact date is not known, enter best estimate.

 

 

 

 

 

 

Date of birth

 

 

 

 

Day

Month

Year

 

 

 

_____     ______

________

 

 

4.

MARITAL STATUS

 

 

 

 

 

 

Mark one circle only.

 

 

 

 

 

 

circle

Never legally married (single)

 

 

 

 

 

 

circle

Legally married (and not separated)

 

 

 

 

 

 

circle

Separated, but still legally married

 

 

 

 

 

 

circle

Divorced

 

 

 

 

 

 

circle

Widowed

 

 

 

 

 

5.

Is this person living with a common-law partner? Common-law refers to two people of the opposite sex or of the same sex who live together as a couple but who are not legally married to each other.

 

 

 

 

 

 

circle

Yes

 

 

 

 

 

 

 

 

circle

No

 

6.  RELATIONSHIP TO PERSON 1

For each person usually living here, describe his/her relationship to Person 1.

 

 

 

 

 

Mark or specify one response only.

 

 

 

 

 

Stepchildren, adopted children and children of a common-law partner should be considered sons and daughters.

 

 

 

 

 

If none of the choices apply, use the "Other" box to indicate this person's relationship to Person 1.

 

 

 

 

 

Examples of "Other" relationships to Person 1:
•  cousin
•  niece or nephew
•  lodger's husband or wife
•  room-mate's son or daughter
•  employee
•  same-sex married spouse

 

 

 

 

 

PERSON 1

 

 

 

 

 

 

 

 

 

 

 

cercle

PERSON 1

 

 

 

 

 

 

 

PERSON 2

 

 

 

 

 

 

 

circle

Husband or wife of Person 1

 

 

 

circle

Opposite-sex common-law partner of Person 1

 

 

 

circle

Same-sex common-law partner of Person 1

 

 

 

circle

Son or daughter of Person 1

 

 

 

circle

Son-in-law or daughter-in-law of Person 1

 

 

 

circle

Grandchild of Person 1

 

 

 

circle

Father or mother of Person 1

 

 

 

circle

Father-in-law or mother-in-law of Person 1

 

 

 

circle

Grandparent of Person 1

 

 

 

circle

Brother or sister of Person 1

 

 

 

circle

Brother-in-law or sister-in-law of Person 1

 

 

 

circle

Lodger or boarder

 

 

 

circle

Room-mate

 

 

 

Other— Specify

 

 

 

 

______________________________

 

 

 

 

______________________________

 

 

 

7.

What is the language that this person first learned at home in childhood and still understands?

 

 

 

 

 

 

If this person no longer understands the first language learned, indicate the second language learned.

 

 

 

 

 

 

circle

English  

 

 

 

 

 

 

circle

French

 

 

 

 

 

 

 

Other — Specify

 

 

 

 

 

 

 

______________________________

 

 

 

 

8.

The Statistics Act guarantees the confidentiality of your census information. Only if you mark "YES" to this question will your personal information be made public, 92 years after the 2006 Census. If you mark "NO" or leave the answer blank, your personal information will never be made publicly available.

 

 

 

 

 

 

Does this person agree to make his / her 2006 Census information available for public release in 2098 (92 years after the census)?

 

 

 

 

circle

Yes

 

 

 

 

 

 

circle

No