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Collection: Original Records > Grass Valley Orphan Asylum

Record of Orphans Half-orphans and Abandoned Children (1900-1914 & 1929) (243 pages)

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r ¥ Anpliratinn for Admissinn TO Jatér Wephan Asylum Bed F Y ‘ PL Sitwated tn ALLLG Date of Application, Name in full of child or children. Place and date of birth. PRO Father’s and mother’s name. 4 Z, Y EPA Where is parents’ marriage certificate recorded ? a When did parents come to California ? 2 L. Where does living parent reside? (Give town, street and number.) ' y 2 fk / CDA. Ca eS If father is living give occupation. 0 ag SOB AOD ot Where and when did father die ? Where and when did mother die ? CALLED , ae fe ia Is there any estate or life insurance ? ee CME 10. What amount will be given for aid to child’s support ? C2 ABO. See ose CAM atA +2 11. Give full address of guardian or parent. fhe ad D “... L222 Vd af eo 12. State fully reasons why child is dependent Ap ws TI DOAtZE Signe 1. Only the guardian, officer or parent knowing the facts should sign this application. Parent, est guardian, relatives, should aid in the support of child if possible; living parent, especially the jather, is expected by the State to pay for maintenance of child. State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Caruiste & Co., 8. F.