ABSTRACT

Date of birth Sex: Boy/Girl Family size and position (for each child in family, indicate sex and age; include foster children, marked F, and deceased children, marked D) sex age MOTHER Age Not working J working part-time jfull-time

Occupation if at work

1. Did you train for a job before you had children? {details, including untrained jobs) FATHER Age Precise occupation

2. Does he have to be away from home at all, except just during the day ? Home every night I up to 2 nights away p.w./3 nights + p.w./normally away I separation or divorce/dead/other

Shiftwork? YES/NO What shifts? 3. Does any other adult live here now, apart from your husband and

yourself? YES /NO

If YES: How does N get on with him/her? Are they good friends?