The object of this Supplemental Schedule is to furnish material not only for
a complete enumeration of children in institutions, but for an account of their
condition. It is important that every inquiry respecting each case be answered
as fully as possible. Enumerators will, therefore, after making the proper
entries upon the Population Schedule (No. 1), transfer the name (with Schedule
paper and number) of every child found in any institution designed for the care
of poor or homeless children, or in any poor-house or other asylum for the
destitute, from Schedule No. 1 to this Special Schedule, and proceed to ask the
additional questions
indicated in the headings of the several columns. Special attention is called to
the questions respecting the child’s antecedents, which are designed to bring
out the proportion of children in institutions who belong to the respectable and
to the vicious classes severally.
Number taken from Schedule No. 1
01 Number of Page
02 Number of Line
03 Name
Residence when at home. -(See note A.)
04 City or Town
05 County (if in same State), or State (if in some other State)
06 Is this child's father deceased?
07 Is this child's mother deceased?
08 Has this child been abandoned by his (or her) parents?
09 Has this child's parents surrendered the control over him (or her) to the
institution?
10 Was this child born in the institution?
11 If not so born, state year when admitted.
12 Is the child illegitimate?
13 Is this child separated from his or her (living) mother?
Antecedents
14 Has he (or she) ever been arrested? If yes, for what alleged offense?
15 Has he (or she) ever been convicted or sentenced?
16 Has the origin of this child been respectable?
17 Has he (or she) been rescued from criminal surroundings?
See Note B.
18 Is this child blind?
19 Is he (or she) a deaf-mute?
20 Is he (or she) an idiot?
NOTE A – Children in institutions may not be residents of the county or State in
which the institution is situated, and in that case their residence when at home
should be stated, in order that they may be accredited to the State or county to
which he properly belongs, and that the county in which the institution is
situated may not be charged with more that its due proportion of dependent
children.
NOTE B – In making entries in columns 18, 19, and 20, an affirmative mark only
will be used, thus /.
Colfax Township Supervisor's Dist No:3; Enumeration Dist No:50; Enumerator: J.M. Tyer | ||||||||||||||||||||
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1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | Notes |
15 | 4 | Deneene Florence |
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