Chapter XIV: Appendix: A

FAMILY SCHEDULE

------------+--------------+----------------------+---------------------------------- Serial | | FAMILY SCHEDULE |Surname: No. |Investigator. |No. in family: |Address: Date: |Source of |No. earning wages: |Floor: No. of rooms: Bath? Rent: | information.|No. depending on |Location on floor: | | family income: | front, rear, right, left. ====================================================================================== | | | | | MARITAL | | |EDUCATION AND INDUSTRIAL | | | | |CONDITION| | | TRAINING.[*] | | | | +---------+ | +---------------------------- Family |Age|Place of|Time |Reason|M|S|W|D|S|Chr|Pol|R|W|M S|M C|M I S|M T|T |W F Members. | | Birth. |in | for |a|i|i|i|e| + | X |e|r|o c|o o|o n c|o r|r |h o | | |N.Y. |coming|r|n|d|v|p| | |a|i|s h|s l|s d h|s a|a |e l | | | |to |.|g|.|.|.| | |d|t| o|. l|. u o|. d|d |r l | | | |N.Y. | |.| | | | | |.|e|i o| e| s o| e|e |e o | | | | | | | | | | | | |.|n l|i g|i t l|a .| | w | | | | | | | | | | | | | | .|n e|n r .|t | | e | | | | | | | | | | | | | | | .| i | | | d | | | | | | | | | | | | | | | | a | | | . | | | | | | | | | | | | | | | | l | | | ------------+---+--------+-----+------+-+-+-+-+-+---+---+-+-+---+---+-----+---+--+--- 1. Man | | | | | | | | | | | | | | | | | | | 2. Woman | | | | | | | | | | | | | | | | | | | (Sex.) | | | | | | | | | | | | | | | | | | | 3. | | | | | | | | | | | | | | | | | | | 4. | | | | | | | | | | | | | | | | | | | 5. | | | | | | | | | | | | | | | | | | | 6. (Lodgers)| | | | | | | | | | | | | | | | | | | 7. | | | | | | | | | | | | | | | | | | | 8. | | | | | | | | | | | | | | | | | | | ====================================================================================== | [*] OCCUPATION. (State exact kind of work done and weekly pay.) |-------+------+-----+------+------+-------+-------+---------------------- Family | At | |Hours|During| |D l p y|During |+ Church Members. |present|Weekly| per | past |Weekly|a o a e|entire | affiliations. | time. | Pay. | day.| year.| Pay. |y s s a|time |B = Baptist. | | | | | |s t t r|in N.Y.|M = Methodist. | | | | | | .|City. |E = Episcopal ------------+-------+------+-----+------+------+-------+-------+P = Presbyterian. 1. Man | | | | | | | |C = Catholic. 2. Woman | | | | | | | |MN = Moravian. (Sex) | | | | | | | +---------------------- 3. | | | | | | | |X Political 4. | | | | | | | | affiliations. 5. | | | | | | | |R = Republican. 6.(Lodgers) | | | | | | | |D = Democrat. 7. | | | | | | | |S = Socialist. 8. | | | | | | | |PB = Prohibition. 9. | | | | | | | +---------------------- 10. | | | | | | | | *See space for 11. | | | | | | | |remarks on other | | | | | | | |side (3) (4). --------------------------------------------------------------------------------------

FAMILY SCHEDULE (REVERSE SIDE)

UNSUCCESSFUL APPLICATIONS | |TRADE UNION, SECRET FOR WORK.* (1) | REASON FOR REFUSAL.* (1) | SOCIETIES.* (2) ------------+------------------------------------------------------------------------ Family |Date|Place: Name |Kind of|Place |Lack of| | |Name of |Why not Members | | and Address| Work |Filled| Skill |Color|Other|Organiz-| member? | | | | | | | | ation |Did you | | | | | | | | | apply? ------------+----+------------+-------+------+-------+-----+-----+--------+---------- 1. Man | | | | | | | | | 2. Woman | | | | | | | | | (Sex.) | | | | | | | | | 3. | | | | | | | | | 4. | | | | | | | | | 5. | | | | | | | | | 6. (Lodgers)| | | | | | | | | 7. | | | | | | | | | 8. | | | | | | | | | ------------+----+------------+-------+------+-------+-----+-----+--------+----------

* (1) Remarks on Unsuccessful Applications:

* (2) Remarks on Trade Unions and Secret Societies:

* (3) Remarks on Occupation:

* (4) Remarks on Education, Trade Training, _etc._: (Where and how was trade learned?)