2021 Census: 2C

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Ce questionnaire est disponible en français

• Please print using CAPITAL LETTERS.
• Mark circles with an "X".

Confidential when completed

This information is collected under the authority of the Statistics Act, R.S.C. 1985, c. S-19.

Step A

1. Do you have a permanent place of residence in Canada presently occupied by one or more members of your family?

• Yes
  • What is the address of your permanent place of residence?
    • Number (and suffix, if applicable)
      (e.g., 302, 151 B, 16 1/2)
    • Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
    • Apartment/unit
    • City, municipality, town, village, Indian reserve
    • Province/territory
    • Postal code
    • Telephone number
    • Enter the name of an adult living at this address.
      • Family name(s)
      • Given names(s)
• No
  • What is the address you give for election purposes?
    If you have no such address, enter your last permanent address in Canada.
    • Number (and suffix, if applicable)
      (e.g., 302, 151 B, 16 1/2)
    • Street name, street type (e.g., DR = Drive), direction (e.g., N = North)
    • Apartment/unit
    • City, municipality, town, village, Indian reserve
    • Province/territory
    • Postal code
    • Telephone number

2. Enter the name and address of the military or government establishment outside Canada to which you are presently attached or, if none, the city or town and the country in which you reside.

• Name of establishment
• Location — City or town
• Country

Step B

1. Including yourself, how many persons usually live at your address (outside Canada) as of May 11, 2021?

Include: all persons who have their main residence at this address, even if they are temporarily away, provided they are:

• Canadian government employees (federal, provincial and territorial) or a member of their family OR members of the Canadian Armed Forces or a member of their family who are stationed outside Canada,
• other Canadian citizens OR persons with Canadian landed immigrant status who are outside Canada on Census Day, but whose permanent residence is in Canada.

• Number of persons

2. Including yourself, list all persons who usually live at your address (outside Canada).

Important: Begin the list with an adult followed, if applicable, by that person's spouse or common-law partner and by their children. Continue with all other persons who usually live at this address.

• Person 1: Family name(s), Given name(s)
• Person 2: Family name(s), Given name(s)
• Person 3: Family name(s), Given name(s)
• Person 4: Family name(s), Given name(s)
• Person 5: Family name(s), Given name(s)
• Person 6: Family name(s), Given name(s)
• Person 7: Family name(s), Given name(s)
• Person 8: Family name(s), Given name(s)
• Person 9: Family name(s), Given name(s)
• Person 10: Family name(s), Given name(s)

Step C

Copy the names in Step B to question 1, at the top of page 4.

Keep the same order.

If more than six persons live at your address (outside Canada), you will need an extra questionnaire. A second questionnaire may be obtained from the representative or official who delivered this one.

1. Name

In the spaces provided, copy the names in the same order as in Step B. Then answer the following questions for each person.

Person 1

• Family name
• Given name

The following questions refer to each person's situation on May 11, 2021, unless otherwise specified.

2. What was this person's sex at birth?

Sex refers to sex assigned at birth.

• Male
• Female

3. What is this person's gender?

Refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents.

• Male
• Female
• Or please specify this person's gender:

4. What are this person's date of birth and age?

If exact date of birth is not known, enter best estimate. For children less than 1 year old, enter 0 for age.

• Day
• Month
• Year
• Age

5. What is this person's marital status?

Mark "x" one circle only.

• Never legally married
• Legally married (and not separated)
• Separated, but still legally married
• Divorced
• Widowed

6. Is this person living with a common-law partner?

Common-law refers to two people who live together as a couple but who are not married, regardless of the duration of the relationship.

• Yes
• No

7. What is the relationship of this person to Person 1?

If none of the responses in the list describes this person's relationship to Person 1, then specify a response under "Other relationship".

Person 1

• Person 1

Person 2

• Husband or wife of Person 1
• Common-law partner of Person 1
• Son or daughter of Person 1 only
• Grandchild of Person 1
• Son-in-law or daughter-in-law of Person 1
• Father or mother of Person 1
• Father-in-law or mother-in-law of Person 1
• Brother or sister of Person 1
• Foster child
• Roommate, lodger or boarder
• Other relationship — specify:

Persons 3-6

• Son or daughter of both Persons 1 and 2
• Son or daughter of Person 1 only
• Son or daughter of Person 2 only
• Grandchild of Person 1
• Son-in-law or daughter-in-law of Person 1
• Father or mother of Person 1
• Father-in-law or mother-in-law of Person 1
• Brother or sister of Person 1
• Foster child
• Roommate, lodger or boarder
• Other relationship — specify:

8. Can this person speak English or French well enough to conduct a conversation?

Mark "x" one circle only.

• English only
• French only
• Both English and French
• Neither English nor French

9. a) What language(s) does this person speak on a regular basis at home?

• English
• French
• Other language(s) — specify:

If this person indicates only one language in question 9. a), go to question 10.

9. b) Of these languages, which one does this person speak most often at home?

Indicate more than one language only if they are spoken equally at home.

• English
• French
• Other language — specify:

10. What is the language that this person first learned at home in childhood and still understands?

If this person no longer understands the first language learned, indicate the second language learned.

• English
• French
• Other language — specify:

11. Has this person ever served in the Canadian military?

Canadian military service includes service with the Regular Force or Primary Reserve Force as an Officer or Non-Commissioned Member. It does not include service with the Cadets (COATS), the Supplementary Reserve or the Canadian Rangers.

Mark "x" one circle only.

• Yes, currently serving in the Regular Force or the Primary Reserve Force
• Yes, but no longer serving in the Regular Force or the Primary Reserve Force
• No

The following questions collect information in accordance with the Canadian Charter of Rights and Freedoms to support education programs in English and French in Canada.

12. Is the address in Canada you provided in Step A, question 1, located in Quebec?

• No
  • Continue with question 13.
• Yes
  • Go to question 16.

13. Did this person do any of their primary or secondary schooling in French in Canada (including immersion)?

Mark "x" one circle only.

• Yes (previously or currently attending)
• No
  • Go to Step D

14. In which type of program was this schooling in French done?

• A regular French program in a French-language school
• A French immersion program in an English-language school
  • Go to Step D
• Both types of programs
• Other program — specify:

15. For how many years did this person attend a regular French program in a French-language school?

• Number of years in primary schooling (including kindergarten and middle school)
  • Number of years
    • Go to Step D
• Number of years in secondary schooling
  • Number of years
    • Go to Step D

16. Did this person do any of their primary or secondary schooling in an English-language school in Canada (including immersion)?

Mark "x" one circle only.

• Yes (previously or currently attending)
• No
  • Go to Step D

17. For how many years did this person do their schooling in an English-language school in Canada (including immersion)?

• Number of years in primary schooling (including kindergarten)
  • Number of years
• Number of years in secondary schooling
  • Number of years

Step D

Comments

Please use the space provided below if you have concerns, suggestions or comments to make about:

• the steps to follow or the content of this questionnaire (for example, a question that was difficult to understand or to answer)
• the characteristics of the questionnaire (for example, the design, the format, the size of the text).

Step E

If more than six persons live at your address (outside Canada), you will need an extra questionnaire. A second questionnaire may be obtained from the representative or official who delivered this one.

You have now completed your questionnaire. Please return it in accordance with instructions from your unit or department.

Thank you for your cooperation.

Reasons why we ask the questions

Steps A and B and question 1 are used to collect contact information and determine who should be included on the questionnaire. They help us ensure that we have counted everyone we need to count and that no one is counted twice.

Questions 2 to 7 provide information about the living arrangements of people in Canada, the family size, the number of children living with one parent or two parents, and the number of people who live alone. This information is used for planning social programs, such as Old Age Security and the Canada Child Benefit. It is also used by municipalities to plan a variety of services such as day care centres, schools, police, fire protection and residences for seniors.

Questions 8 to 10 are used to provide a profile of the linguistic diversity of Canada's population. This information is used to estimate the need for services in English and French, and to better understand the current state and the evolution of Canada's various language groups.

Question 11 provides information on the number of people with Canadian military experience. Governments will use this information to develop programs and services to meet the changing needs of the Veteran population.

Questions 12 to 17 collect information in accordance with the Canadian Charter of Rights and Freedoms to support education programs in English and French in Canada.

The law protects what you tell us

The confidentiality of your responses is protected by law. All Statistics Canada employees have taken an oath of secrecy. Your personal information cannot be given to anyone outside Statistics Canada without your consent. This is your right.