Page 1
Complete online
Siobhán Carey
Registrar General, Northern Ireland
www.census.gov.uk/ni
Your individual access code is:
OR fill in this paper questionnaire and post it
back using the pre-paid envelope supplied.
Your data are protected by law.
There is more information in the leaflet that
comes with this questionnaire.
Declaration
Where you can get help
If your address is incorrect or missing, enter
your correct address below:
This questionnaire has been completed to the
best of my knowledge and belief.
If you have lost your envelope, please return to:
FREEPOST Census 2021
www.census.gov.uk/ni
Helpline 0800 328 2021
NGT (18001) 0800 328 2021
Language helpline 0800 587 2021
I4
FREEPOST
Census 2021
We need your help with the census, it gathers
vital information for planning services such as
education and health.
Please complete your questionnaire by
21 March 2021 or as soon as possible
afterwards.
If you prefer, you can complete the questionnaire
online:
1. Go to www.census.gov.uk/ni
2. Click Start Census and enter the individual
access code on the front of this questionnaire.
3. Answer the questions and submit.
By law, you must take part in the census.
You could face a fine if you don’t participate or if
you supply false information. There is no penalty
for not completing the questions on religion or
sexual orientation.
Thank you for taking part.
Postcode
Signature Date
Individual Questionnaire
Northern Ireland
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Who should complete this questionnaire?
Everyone who has stayed, or intends to stay, in the United Kingdom for 3 months or more needs to be included
on a census questionnaire.
This Individual Questionnaire is for four types of people:
• those living in a private household who have requested an Individual Questionnaire;
• those who usually live in the UK and have stayed, or expect to stay, in a communal establishment (excluding
prison) for 6 months or more;
• those who usually live in the UK and are currently imprisoned and convicted with a sentence of
12 months or more OR are in prison awaiting sentencing;
• those living in a communal establishment who do not have another usual UK address.
A communal establishment is an establishment providing managed residential accommodation. ‘Managed’ in
this context means full-time or part-time supervision of the accommodation. If you are living in a communal
establishment you should receive this questionnaire from your establishment manager.
Examples of communal establishments include student halls of residence, boarding schools, Armed Forces bases,
hospitals, care homes and prisons.
You should:
•
use black or blue ink to answer;
•
tick your answers within the box like this:
•
print in capital letters within the boxes, one letter per box, like this:
•
correct any mistakes by filling in the box like this: or:
•
continue onto the next line (if possible) when a word will not fit, like this:
•
follow the instructions and leave any questions or pages you
do not need to answer completely blank; any marks or lines can be mistaken for answers.
What is a communal establishment?
How should I complete my questionnaire correctly?
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Important information
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What type of accommodation is this?
Are you answering the questions on behalf of someone else?
If you are answering on behalf of someone else, please record their position and not your own.
What is your position in this establishment?
A communal establishment (for example student hall of residence, boarding school,
Armed Forces base, hospital, care home, prison)
A private or family household Individual questions on page 4
Yes - please ensure their details and not your own are inserted in this questionnaire, including question A3 below
No, I am answering for myself
Resident (for example student, member of Armed Forces, patient, detainee)
Staff or owner
Family member or partner of staff or owner
Staying temporarily (no usual UK address)
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A1
A2
A3
Now Individual questions on page 4
Start here
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Page 4
Are you a schoolchild or student in full-time education?
During term time, where do you usually live?
What is your country of birth?
What is your name?
What is your date of birth?
What year did you come to live in Northern Ireland?
What is your sex?
What is your marital or civil partnership status?
At the address on the front of this questionnaire
At another address
Northern Ireland
England
Scotland
Wales
Republic of Ireland
Elsewhere, write in the current name of the country
Yes
No
Female
Male
Single (never married and never in a civil partnership)
Married
Separated, but still
legally married
Divorced
Widowed
In a civil partnership
Separated, but still legally
in a civil partnership
Formerly in a civil
partnership which is
now legally dissolved
Surviving partner from a
civil partnership
One year ago, what was your usual address?
If you had no usual address one year ago, state
the address where you were staying.
The address on the front of this questionnaire
Student term-time / boarding school address in
the UK, write in term-time address below
Another address in the UK, write in below
Outside the UK, write in country
What passports do you hold?
What is your ethnic group?
How would you describe your national identity?
Tick all that apply.
Tick one box only.
Tick all that apply.
United Kingdom
Ireland
Other, write in
White
Chinese
Irish Traveller
Roma
Indian
Filipino
Black African
Black Other
Mixed ethnic group, write in
British
Irish
Northern
Irish
English
Scottish
Welsh
Other, write in
None
Any other ethnic group, write in
First name(s)
Last name
Day Month Year
Year
Postcode
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7
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9
5
6
7
1
2
8
3
4
9
10
12
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Individual questions
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What is your main language?
How well can you speak English?
How is your health in general?
English
Other, write in (including British / Irish Sign Languages)
Very well Well Not well Not at all
Very good Good Fair Bad Very bad
What religion, religious denomination or body
do you belong to?
What religion, religious denomination or body
were you brought up in?
Roman Catholic
Presbyterian Church in Ireland
Church of Ireland
Methodist Church in Ireland
Other, write in
Roman Catholic
Presbyterian Church in Ireland
Church of Ireland
Methodist Church in Ireland
Other, write in
None
None
No ability Understand Speak Read Write
No ability Understand Speak Read Write
Daily Weekly Less often Never
Daily Weekly Less often Never
Can you understand, speak, read or write Irish?
Can you understand, speak, read or write Ulster-Scots?
How often do you speak Irish?
How often do you speak Ulster-Scots?
Tick all that apply.
Tick all that apply.
Are your day-to-day activities limited because of a
health problem or disability which has lasted, or is
expected to last, at least 12 months?
Do you look after, or give any help or support to,
anyone because they have long-term physical or
mental health conditions or illnesses, or problems
related to old age?
Do you have any of the following conditions
which have lasted, or are expected to last, at
least 12 months?
Include problems related to old age.
Exclude anything you do in paid employment.
Tick all that apply.
No
Yes, limited a little
Yes, limited a lot
No
Yes, 1 to 19 hours a week
Yes, 20 to 34 hours a week
Yes, 35 to 49 hours a week
Yes, 50 hours or more a week
Deafness or partial hearing loss
Blindness or partial sight loss
A mobility or dexterity difficulty that requires the
use of a wheelchair
A mobility or dexterity difficulty that limits basic
physical activities (for example walking or dressing)
An intellectual or learning disability (for example
Down syndrome)
A learning difficulty (for example dyslexia)
Autism or Asperger syndrome
An emotional, psychological or mental health
condition (for example depression or schizophrenia)
Frequent periods of confusion or memory loss
(for example dementia)
Long-term pain or discomfort
Shortness of breath or difficulty breathing (for
example asthma)
Other condition (for example cancer, diabetes or
heart disease)
No condition
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15
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15
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15
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15
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15
15
16
19
13
14
17
18
20
22
21
Individual questions – continued
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Which of the following best describes your
sexual orientation?
Straight / Heterosexual
Gay or Lesbian
Bisexual
Other sexual orientation, write in
Prefer not to say
Have you completed an apprenticeship?
For example, trade, advanced, foundation, modern.
Yes
No
Are you aged 16 or over?
Yes
No
Have you achieved any other qualifications?
Tick all that apply.
AS, A level or equivalent
2 or more A levels, 4 or more AS levels
1 A level, 2-3 AS levels
1 AS level
NVQ or equivalent
NVQ level 3, BTEC National, OND or ONC,
City and Guilds Advanced Craft
NVQ level 2, BTEC General, City and Guilds Craft
NVQ level 1
GCSEs or equivalent
5 or more GCSEs (A*-C, 9-4), O levels (passes)
or CSEs (grade 1)
Any other GCSEs, O levels or CSEs (any grades)
Other or no qualifications
Any other qualifications, equivalent unknown
No qualifications
Have you achieved a qualification at
degree level or above?
For example, degree, foundation degree, HND or
HNC, NVQ level 4 and above, teaching or nursing.
Yes
No
Have you ever done any paid work?
Yes, in the last 12 months
Yes, but not in the last 12 months
No, have never worked
In the last seven days, were you doing any
of the following?
Tick all that apply.
Include casual or temporary work, even if
only for one hour.
Working as an employee
Self-employed or freelance
Temporarily away from work ill,
on holiday or temporarily laid off
On maternity or paternity leave
Doing any other kind of paid work
None of the above
Which of the following describes what you were
doing in the last seven days?
In the last four weeks, were you actively looking
for any kind of paid work?
If a job became available now, could you start it
within two weeks?
In the last seven days, were you waiting to start a
job already accepted?
Tick all that apply.
Retired (whether receiving a pension or not)
Studying
Looking after home or family
Long-term sick or disabled
Other
Yes
No
Yes
No
Yes
No
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42
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34
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34
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34
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34
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34
24
26
27
23
25
33
28
29
30
31
32
Individual questions – continued
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There are no more questions.
the back page for instructions explaining
how to return your questionnaire, then
the Declaration on the front page.
Answer questions 35 to 41 for your main job or, if
not working, your last main job.
Your main job is the job in which you usually work
(worked) the most hours.
In your main job, what is (was) your
employment status?
What is (was) the name of the organisation
or business you work (worked) for?
What is (was) the main activity of your
organisation, business or freelance work?
Do (did) you supervise or oversee the work of
other employees on a day-to-day basis?
What is (was) your full job title?
Briefly describe what you do (did) in your main job.
If you are (were) self-employed in your own
business, write in your business name.
For example, RETAIL ASSISTANT, OFFICE CLEANER,
DISTRICT NURSE, PRIMARY SCHOOL TEACHER.
For example, CLOTHING RETAIL, GENERAL HOSPITAL,
PRIMARY EDUCATION, FOOD WHOLESALE.
If you are (were) a civil servant, write CIVIL SERVICE.
Do not state your grade or pay band.
If you are (were) a local government officer, write
LOCAL GOVERNMENT and give the department name.
Yes
No
Employee
Self-employed or freelance without employees
Self-employed with employees
No organisation or work (worked) for a private individual
In your main job, how many hours a week
do (did) you usually work?
Include paid and unpaid overtime.
0 to 15 16 to 30 31 to 48 49 or more
Not currently working or studying
Work or study mainly at or from home
No fixed place
The address below, write in
Driving a car or van
Passenger in a car or van
Car or van pool, sharing driving
Bus, minibus or coach (public or private)
Taxi
Train
Motorcycle, scooter or moped
Bicycle
On foot
Other
What is the name and address of your main place
of work or course of study (including school)?
How do you usually travel to your main place of
work or study (including school)?
Answer for the place where you spend the most time.
Tick one box only - for the longest part by distance.
If student (or schoolchild), provide your study address.
If working (even if ill, on maternity leave, holiday or
temporarily laid off), provide your main work address.
Postcode
(Name, Organisation, Branch, Campus, School)
Country
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44
44
34
39
40
35
36
37
38
41
42
43
Individual questions – continued
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How do I return my completed questionnaire?
Remember to sign the Declaration on the front page
before you return your completed questionnaire.
All the personal information that you give us will be kept strictly
confidential and will only be used for statistical purposes. Depending
on which type of accommodation you live in, you should return your
questionnaire using the instructions below.
If you live in a communal establishment
• Put your completed and signed questionnaire into the pre-paid return
envelope supplied and give it to your establishment manager for return
or if you prefer and are able you can also post back directly using the
pre-paid return envelope.
• If you have lost your pre-paid return envelope you can put it in a plain
envelope and return it to the freepost address below.
If you live in a private household
• Post your completed and signed questionnaire back separately in the
pre-paid envelope supplied.
• If you have lost your pre-paid return envelope you can put it in a plain
envelope and return it to the freepost address below.
FREEPOST
Census 2021
Important information
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