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
/.
Wayne Twp Supervisor's Dist No:1; Enumeration Dist No:330; Enumerator: A. J. Schoonover | ||||||||||||||||||||
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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 |
Phelan Jas | born in Poorhouse | Jones Co. | no | no | no | yes | yes | yes | no | no |