CUSSiriCATION DATA 



Kt^TThL STATUS: 



Married 



Single-- 



Widowed, divorced, etc. 



-70-1 



- -2 



- 2l 



la. Sou many people eat dinner at home 

 with you7 (CIRCLE ONE) 



What was the last grade you completed In 



school? 



Less than 8th 76-I 



8th through 12th — 2 



College 3 



I ASKED OKLY OF COLORED HOUSEHOLDS | 



1 2 3 1* 5 6 7 

 71-1 -2 -3 -1* -5 -6 -7 -8 -9 :C 

 I IF NOT SIMGLE, ASK QUESTIONS lb ABD Ic [ 



lb. 



How many children eat dinner at 

 home? (CIRCLE ONE) 



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 



pg LBSS THAN 15 rSABS . ASK QUBSTION 6a | 



6a. 



1 23U56789 10or more 

 What are their approximate ages? 



Vhere did you ccoe from? 



I IF HARRIED. ASK QUETION Id | 



Id. What is_ your husband's job? 



Executive, professional, mer- 

 chant or own business ' 



Clerical or sales personnol----- 

 Manual skilled, semi-skilled 



or unskilled worker 



Retired, unemployed, or student - 

 Other (SPECIFY) 



-72-1 



- -2 



Do you work? 



Yes- 

 Ho- 



-73-1 

 - -2 



I IF "YES . " ASK QUESTION 2a | 



2a. What Is your Job? 



Executive, professional, mer- 

 chant or own business 



Clerical or sales personnel 



Manual skilled, semi-skilled 



or unskilled worker 



Retired, unemployed, or student- 

 Other (SPECIFY) 



I HAND RESPONDENT CARD 



Would you tell me which letter Indicates 

 the age you are? (CIRCLB ONE) 



A B C D E 



7U-I -2 -3 -It ^ 



I HAMD RESPONDENT CARD #5 | 



Would you tell me Into which group your 

 total family Income falls? (CIRCLE ONE) 



Northern state — 

 Southern state-- 

 Forelgn country- 



I ASK ALL RESFONDEMTS" 



7. Where were you born? 



Northern state 



Southern state 



Foreign country (SPECIFY) 



-77-1 

 - -2 



IF NATIVE BORN 



Yes- 

 No— 



Were both of your parents 

 born In this country? 



I IF "NO" ] 



In what country (s) were they born? 

 (SPECIFY) 



Father 



-78-1 

 - -2 



Mother 



Ten years ago did you live in. 



open country, ■ 



suburbs, 



city? 



-79-1 



- -2 



- -3 



10. The religious background of a family at 

 times influences eating habits. With what 

 religion Is your family most closely asso- 

 ciated? 



Protestant -^ 



Catholic -5 



Jewish -6 



Other (SPECIFY) 



AUTOMATIC CLASSIFICATION 



U. RACE: White - 90-l 



- -2 



- -3 



Negro 



Other non-white- 



12. LOCATION OF DWKLLIKG: 



City — - 

 Suburb - 



-It 



Clty_ 



Interviewer's Slgnature_ 



60 



Time Interview Ccnpleted: 

 ^A.M. P.H. 



IHT.^UP. .D.C.6P- 7*8 Jt 



