Family Schedule

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00
 

Serial No.
 

Date:
 

Investigator.

Source of information.
 

FAMILY SCHEDULE.
 

No. in family:

No. earning wages:

No. depending on family income:
 

Surname:

Address:

Floor:                No. of rooms:                Bath?

Location on floor:    front,    rear,    right,    left.
 

Rent:
 

Family
 

Age.
 

Place of Birth.
 

Time,
in N. Y.
 

Reason for
coming to N. Y.
 

MARITAL CONDITION
 

Chr.

+
 

Pol.
X
 

EDUCATION AND INDUSTRIAL TRAINING.*
 

Members,
 

Mar.
 

Sing.
 

Wid.
 

Div.
 

Sep.
 

Read.
 

Write.
 

Mos. in
School.
 

Mos. in
College.
 

Mos. in
Industrial sch.
 

Mos. at
Trade.
 

Trade.
 

Where
followed.
 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

(Sex.)
 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

6. (Lodgers)
 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

b
 

Family
 


 


 


 

* OCCUPATION.    (State exact kind of work done and weekly pay.)
 


 

Members.
 

At present time.
 

Weekly
Pay.
 

Hours
per day.
 

During past year.
 

Weekly
Pay.
 

Days lost
past year.
 

During entire time in New York City.
 

+ Church affiliations.

B=Baplist.

M=Methodist.

E=Episcopal.

P=Presbyterian.

C=Catholic.
 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

MN=Moravian.
 

(Sex.)
 


 


 


 


 


 


 


 


 


 


 

X Political affiliations.
R=Republican.
 


 


 


 


 


 


 


 


 

D=Democrat.
 

6. (Lodgers)
 


 


 


 


 


 


 


 

S=Socialist.
PB=Prohibition.
 


 


 


 


 


 


 


 


 


 

* See space for
remarks on other
 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 

side (3) (4).
 

I-I
vo