APPENDIX. 263 



mother, also her maiden name ? Designation and prin- 

 cipal titles of yourself, your father, and the father of your 

 mother ? Your father and mother, are they respectively 

 English, Welsh, Scotch, Irish, Jewish, or foreign ? If 

 foreign, of what country ? Wholly or in what degree ? 

 Was either your- father or your mother descended from 

 persons persecuted for political or religious opinions, or 

 from political or religious refugees ? If so, state the 

 precise relationship. Mention whether their political 

 or religious opinions became traditional in the family. 

 Occupation of yourself, your father, and the father of 

 your mother ? Specify any interests that have been 

 very actively pursued by them, in addition to their 

 regular occupation or profession. 



All the questions in the following paragraph are 

 asked concerning yourself, your father, and your mother 

 respectively : 



Date of the birth of? Place of the birth ,of 

 (if you do not remember that of either your father 

 or mother, state where he or she resided in early 

 life) ? Mention if it was in a large or small town, 

 a suburb, a village, or a house in the country, To 

 what religious bodies have you (self, father and mother) 

 respectively belonged ? To what political parties ? 

 Health at the various periods of life ? In early adult 

 life, what was your height (to be estimated, where not 

 accurately remembered)? Was there anything dis- 



