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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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Anplication for Admission TO 7 f LLACLAL Lee J Orphan Asylumes, Be Ee @ ieee. cS Ag ‘ Situated in PA AAA. FS bt Bliker seed wis é Date of Application, Z Z Cd, of 4 TOG, Name in full of child or children. ~i ee Protea oY Place and date of birth. ta BO & ig a) es Father’s and mother’s name. Where is Ts marriage certificate 2. When did parents come to California? (Give town, street and number.) Meee ee 24, tla, [4 94-4 dn. Where does living parent reside? If father is living give occupation. ad Where and when did father die? Where and when did mother die? Is there any estate or life insurance? ies 10. What amount will be given for aid to child’s support? oe , 4 11. Give full address of guardian or parent. 12. State fully reasons why child fe isoenctent All the above is absolutely true, to my best knowledge and belief. ‘ Ap Sign MS recfo iThapawnn J 1. Only the guardian, officer or parent knowing the facts should sign, this application. 2. Parent, estate, guardian, relatives, should aid in the support of child if possible; living parent, especially the father, is expected by the State 1 “ f f i to pay for maintenance of child. State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. CarRLisLte & Co., S. F