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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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Page: of 243
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Place and date of deat
When and where were parents mafried? 4:
8. Where is marriage certificate recorded?
g. Year father came to California?
10. Which parent is living?
11. Residence of parent.
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Relation of applicant to child LZ,
13. Full address of guardian erparent?
14. the child inmate of an institution?
15. Name and address of institution? hee
16, What amount will be given for aid of child ?
Note I. This application may be used for more than ONE child of one fami
Note 2, This application must be recorded in “Record of Orphans" and fort
Note 3. This application cannot remain in effect for more than one fiscal
of each vear for the ensuing fiscal pear.
What amount will be given for aid of child....
than ONE child of one
lof "and f
16
ord of Orphan:
pplication may be u
.pplication must be re
APPLICATION FOR ADMISSION TO INSTITUTION.
16.
“Record of Orphans” and forward.
This application may be used for more than ONE chil
This application must be recorded in
Note 1
forwarded at once to Se
Form No. 5
What amount will be given for aid of chila#t4-~
etc
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Application for Admission to
Vj Fu Institution)
Cr (Ly. A amide lh,
In the matter of the apy 4 A AEX l’, VED: or the admission
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2. Status of child, Ace. Orptran , Half Orphan Abamtorred
3. Has parent or child any estate, or are they or either of them heir to any estate? If so, describe said estate, its location and value, including insurance, if any
the child #etaac.ever been legally adopted? If so, by whom?.... 222’
(ALLA... Nativity Catia oreetac. —
4. Have
Father’s name..tZ Uk dehy 5
Place and date of death X. Z
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6. Mother’s name..424214...(/..
Place and date of death ea Ye
When and where were parents married?
Where is marriage certificate recorded?
8
9. Date father came to California?
10. Which parent is living?
_
1. Residence of parent..COQ2<%
a
v4 S . . 9 “4 12. Relation of applicant to child ? VA 2
8. Full address of guardian or parent ?. Si
4, the child inmate of an institution?
5. Name and address of institution?
6. What amount will be given for aid of child j.--------per year. By whom?,
Note 1. This application may be used for more than ONE child of one family, but not for children of differ Note 2. This application must be recorded in “Re: ord of Orphans” a: warded at once to Sec ary of Boal
Form No. 5—APPLICATION FOR ADMISSION TO INSTITUTION
A. Carlisle & Co., 8, F.
we.
x ve ’
Whatean 4a tara
per year. By whom?.......
n of different familic ‘
tary of Board of Control, Sacramento, California.
family, but not for ct
A. Carlisle & Co., 8
per year. By whom?
. but not for children of different families. ,
ed at once to Secretary of Board of Control, Sacramento, California.
of one family,
Form No. 5—APOI IAA TION POP ADMISSION TO. INSTIVUTI“~
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er?.. ZZ Ata ® To County, (Li4-9. Mother
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