CLASSIFICATION DATA 



MiffirrAL STATUS: 



Married 



Single 



Widowed, divorced, otc- 



-70-1 



- -2 



- li 



^. What was the last grade you completed In 

 school? 



Less than 8th 76-I 



8th through 12th 2 



3 



la. How many people eat dinner at home 

 with you'.' {CIRCLE ONE) 



College 



ASKED ONLY OF COLORED HOUSEHOLDS | 



1 2 3 i* 5 6 7 

 71-1 -2 -3 -J* -5 -6 -7 



-9 -0 



IF NOT SINGLE. ASK QUESTIONS lb AHD Ic 



lb. How many children eat dinner at 

 home? (CIRCLE ONE) 



1 23U56789 10or more 

 What are their approximate ages? 



9 10 or more 6. How long have you lived In this city? 



1 year or less 



More than 1 to 5 years 



More than 5 to 10 years 



More than 10 to 15 years 



More than 15 years 



[if LESS THAN 15 YEARS. ASK QUESTION SeT 



6a. Whore did you come from? 



I IF MARRIED, ASK QUESTION ld~| 



Id . What jj^ your husband ' s j ob ? 



Executive, professional, mer- 

 chant or own business — ' 



Clerical or sales personnel- 



Manual skilled, semi-skilled 



or unskilled worker 



Retired, unemployed, or studeot-- 

 Other (SPECIFY) 



-72-1 

 - -2 



2 . Do you work? 



I IF "YES." ASK QUESTION 2a~ 

 2a. What is your Job? 



Yes- 



No-- 



-73-1 

 - -2 



Executive, professional, mer- 

 chant or own business 



Clerical or sales personnel 



Manual skilled, semi-skilled 



or unskilled worker , 



Retired, unemployed, or student 



Other (SPECIFY) 



1 HAJtP RESPONDENT CARD §k 



Would you tell me which letter indicates 

 the age you are? (CIRCLE ONE) 



B 



E 



71* -1 -2 -3 -U _^ 

 . I HAND RESPONDENT CARD #5"[ 



k . Would you tell me into which group your 

 total family Inccme falls? (CIRCIi ONE) 



A 



75-1 



E 



i2 



Northern state — 

 Southern state — 

 Foreign country - 



ASK ALL RESPONDENTS 



Whore were you born? 



Northern state 



Southern state 



Foreign country (SPECIFY) 



-77-1 

 - -2 



IF NATIVE BORN 



Wore both of your parents 

 born in this country? 



T08- 

 NO" 



-78-1 

 - -2 



I IF "NO" 



In what country(8) were they born? 



(SPECIFI) 



Father 



Mother 



Ten years ago did you live in. 



open country, 



suburbs, 



city? 



-79-1 



- -2 



- -3 



The religious backgroupd of a family at 

 times influences eating habits. With what 

 religion is your family most closely asso- 

 ciated? 



Protestant 



Catholic 



Jewish 



Other (SPECIFY) 



AUTOMATIC CLASSIFICATION 



White 



Negro 



Other non -white - 



LOCATION OF DWELLING: 



City— - 

 Suburb - 



J. 



Tela. No. 



Add re e s 



Interviewer ' a Signature_ 



City_ 



State 



Data 



U6 



Time Interview Ccnpletad: 

 A.M. P .M. 



IHT,DUr.,0.C-90- JH'T 



