Family Historical Questionnaire

Name ______________________________________ Phone Number____________________________

E-mail Address ______________________________________________

Questionnaire Guide for Life Story Interview with Immigrants

1, Where were you born (town / village)? ___________________________________________

2. What are your parents' names? Father ___________________________________________ Mother (maiden) ______________________________

3. How many brothers and sisters do you have? ____________________________________

4. Was there a family nickname ? _____________________________________________________

5. When did you immigrate? __________________________________________________________

6. Friends or relatives in the United States or Canada who provided assistance to you when you immigrated? Name Relationship _______________________________ ______________________________________ _______________________________ ______________________________________

7. Name of the ship on which you traveled to the United States / Canada? ________________________________________________________________________________

8. Any memories of your voyage? If so, what are they? ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________

9. Did you come to the United States / Canada with other members of your family? ________ Yes ________ No

10.vDid you regard your move as permanent? _______Yes _______ No ________Uncertain

11. Arrival Date Port of Entry _______________________________ _____________________________________

12. Jobs you had over the years in the United States / Canada? Any organizations you joined after you arrived in the United States / Canada? If so, which ones? ______________________________________________________________________________________________ ______________________________________________________________________________________________

13. Ever return to Malta for a visit? Yes _________ No __________

14. Nationality of your spouse? __________________________________________________________

15. How many children do you have? __________

16. How do you regard yourself today? As Maltese, American, Canadian?

Family History

17. What were your grandparents' names and birthplaces? Name Birthplace

Maternal Grandfather: ______________________________ _________________________________

Grandmother: _____________________________ _________________________________ (maiden)

Paternal Grandfather: _______________________________ _________________________________

Grandmother: _______________________________ _________________________________ (Maiden)

18. Please tell us about your grandparents' occupations & social activities:

Maternal Grandfather occupation: ______________________________

Grandmother occupation: ______________________________

Social Activities: _____________________________________________________________________________ ________________________________________________________________________________________________

Paternal Grandfather occupation: ______________________________ Grandmother occupation: ______________________________

Social Activities: _____________________________________________________________________________ ________________________________________________________________________________________________

19. Memories of your grandparents? If so, what are they?

20. Do you have any photos of your grandparents? _______ Yes ________ No If so, would you willing to provide copies? ________ Yes ________ No

21. Did your grandparents have any favorite sayings? If so, please state: ______________________________________________________________________________________________________

22. When and where did your grandparents pass away? Maternal Date Place Grandfather: ______________________________ _________________________________ Grandmother: _____________________________ _________________________________ Paternal Grandfather: _______________________________ _________________________________ Grandmother: _______________________________ _________________________________

23. Parents: Father Mother (maiden name) Names: _______________________ _______________________ Place of Birth: _______________________ _______________________ (town / village)

Education Level: ______________________ _______________________ Occupation: ______________________ _______________________ Nicknames: ______________________ _______________________

24. Do you have any photos of your parents? _______ Yes ________ No If so, would you willing to provide copies? ________ Yes ________ No

25. Did your parents have any favorite sayings? If so, please state:

26. Did your parents ever talk about their achievements in their lives? Achievements: ___________________________________________________________________________________

27. Did your parents ever talk about any special experiences or interest? If so, what are they? __________________________________________________________________________________________________ __________________________________________________________________________________________________

28. What were your parent's ages at the time of your birth: Father _________ Mother:__________ Birth and Infancy

29. When and where were you born? When Were ____________________ _____________________

30. What is your full name? ____________________________________________________________ (maiden name if applicable)

31. Who raised you as a child? ____________________________

32. What was the first language you spoke? _______________________________________________________________________________________________

33. Was the Maltese language spoken in your household while you were growing up? _______ Yes _______No

Schools Days

34. What were the names and locations of the schools you attended in Malta, United States & Canada? Names Location _________________________________________ ________________________________ ________________________________________ ________________________________ ________________________________________ ________________________________

35. Do you have any special school memories, if so what are they?

36. What was your highest level of education completed?

37. What was your favorite subject(s) in school ? ___________________________________________________________________________________________________

38. Did you participate in any sporting or recreational activities while in school? If yes, please identify the sport or activity?

39. What kind of work or profession(s) did you have during your life? 40. Did you, your parents, or your grandparents serve in the military?

Name of service member __________________________ Relationship (self, parent, grandparent)___________________ Branch of service______________________________________ Years (e.g. 1940-1945)__________________________________