Data Cart

Your data extract

0 variables
0 samples
View Cart

Questionnaire Text

2023 ACS 2016 ACS 2000 1% 1910 1%
2022 ACS 2011 ACS 1990 1% 1900 1%
2021 ACS 2006 ACS 1930 1%
top
2023 ACS
Questionnaire form view entire document:  text  image
6. What is Person X's race? Mark (X) one or more boxesAND print origins.
[ ] White - Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. -->___________________________

[ ] Black or African Am. -Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. -->_________________________

[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe(s), for example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. --> ______________________
[ ] Chinese
[ ] Vietnamese
[ ] Native Hawaiian
[ ] Filipino
[ ] Korean
[ ] Samoan
[ ] Asian Indian
[ ] Japanese
[ ] Chamorro
[ ] Other Asian -- Print, for example, Pakistani, Cambodian, Hmong, etc. --> _____________________
[ ] Other Pacific Islander ? Print, for example, Tongan, Fijian, Marshallese, etc. -->______________________
[ ] Some other race -- Print race or origin. -->
____________________________________________________

top
2022 ACS
Questionnaire form view entire document:  text  image
6. What is Person X's race? Mark (X) one or more boxesAND print origins.
[ ] White - Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. -->___________________________

[ ] Black or African Am. -Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. -->_________________________

[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe(s), for example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. --> ______________________
[ ] Chinese
[ ] Vietnamese
[ ] Native Hawaiian
[ ] Filipino
[ ] Korean
[ ] Samoan
[ ] Asian Indian
[ ] Japanese
[ ] Chamorro
[ ] Other Asian -- Print, for example, Pakistani, Cambodian, Hmong, etc. --> _____________________
[ ] Other Pacific Islander ? Print, for example, Tongan, Fijian, Marshallese, etc. -->______________________
[ ] Some other race -- Print race or origin. -->
____________________________________________________

top
2021 ACS
Questionnaire form view entire document:  text  image
6. What is Person X's race? Mark (X) one or more boxesAND print origins.
[ ] White - Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. -->___________________________

[ ] Black or African Am. -Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. -->_________________________

[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe(s), for example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. --> ______________________
[ ] Chinese
[ ] Vietnamese
[ ] Native Hawaiian
[ ] Filipino
[ ] Korean
[ ] Samoan
[ ] Asian Indian
[ ] Japanese
[ ] Chamorro
[ ] Other Asian -- Print, for example, Pakistani, Cambodian, Hmong, etc. --> _____________________
[ ] Other Pacific Islander ? Print, for example, Tongan, Fijian, Marshallese, etc. -->______________________
[ ] Some other race -- Print race or origin. -->
____________________________________________________

top
2016 ACS
Questionnaire form view entire document:  text  image
6. What is Person X's race? Mark (X) one or more boxes.
[ ] White
[ ] Black or African Am.
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on._________________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander -- Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. --> ____________________________________________________
Questionnaire instructions view entire document:  text  image
6. Mark all boxes for the appropriate races.
The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.
The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.
People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.
If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the person's enrolled or principle tribe(s) in the space provided (for example, Navajo nation, Blackfeet Tribe, Muscogee (Creek) nation, Mayan, Doyon, native Village of Barrow Inupiat Traditional Government, and so on).
If you mark the "Other Asian" box, print the name of the specific Asian group(s) in the space provided (for example, Pakistani, Cambodian, Hmong, Laotian, Bangladeshi, and so on.)
If you mark the "Other Pacific Islander" box, print the name of the specific Pacific Islander group(s) in the space provided (for example, Tongan, Fijian, Marshallese, Palauan, Tahitian, Papua New Guinean, and so on.)
If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.
This question should be answered by ALL persons.

top
2011 ACS
Questionnaire form view entire document:  text  image
6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander ?Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image
6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


top
2006 ACS
Questionnaire form view entire document:  text  image
6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image
6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


top
2000 1%

No questionnaire text is available for this sample.


top
1990 1%
Questionnaire form view entire document:  text  image
4. Race
Fill ONE circle for the race that the person considers himself/herself to be.
If Indian (Amer.), print the name of the enrolled or principal tribe.
If Other Asian or Pacific Islander (API), print one group, for example: Hmong, Fijian, Laotian, Thai, Tongan, Pakistani, Cambodian, and so on.
If Other race, print race.

[] White
[] Black or Negro
[] Indian (Amer.) (Print the name of the enrolled or principal tribe.)

____________________
[] Eskimo
[] Aleut
Asian or Pacific Islander (API)
[] Chinese
[] Japanese
[] Filipino
[] Asian Indian
[] Hawaiian
[] Samoan
[] Korean
[] Guamanian
[] Vietnamese
[] Other API
____________________
[] Other race (Print race)

Fill ONE circle for the race each person considers himself/herself to be. If you fill the Indian (Amer.) circle, print the name of the tribe or tribes in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe(s). If you fill the Other API circle [under Asian or Pacific Islander (API)], only print the name of the group to which the person belongs. For example, the Other API category includes persons who identify as Burmese, Fijian, Hmong, Indonesian, Laotian, Bangladeshi, Pakistani, Tongan, Thai, Cambodian, Sri Lankan, and so on. If you fill the Other race circle, be sure to print the name of the race. If the person considers himself/herself to be White, Black or Negro, Eskimo or Aleut, fill one circle only. Please do not print the race in the boxes. The Black or Negro category also includes persons who identify as African-American, Afro-American, Haitian, Jamaican, West Indian, Nigerian, and so on. All persons, regardless of citizenship status, should answer this question.?

top
1930 1%

No questionnaire text is available for this sample.


top
1910 1%
Questionnaire form view entire document:  text  image
33. Tribe of this Indian
Questionnaire instructions view entire document:  text  image
Columns 33, 34, and 35. Tribal Relations. ? If the Indian was born in this country answers should be obtained, if possible, to inquiries 12, 13, and 14, relating to the state or territory of birth of the person and of his or her parents. In any event, take particular pains to secure the name of the tribe with which the person is connected and the name of the tribe of each of his or her parents, and enter the name in columns 33, 34, and 35.

top
1900 1%

No questionnaire text is available for this sample.