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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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Application for Adinission TO AA LEELA An rphan Asylum Situated in Aa Vallee A Date of Application, eee 19.L/ Name in full of child or children. ce f Chiesa Ps Place and date of birth. a , ; . ag Te , 2 Father’s and mother’s name. Jie cap foe eae agt7 y ECP EIPZE AY Cenc Where is parents’ marriage certificate recorded? When did parents come to California? , ar 4 , Pet aaa Where does living parent reside? (Give town, street and number.) If father is living give occupation. denny ee Where and when did mother die? f see, Cg Ze KW Is there any estate or life insurance? ee 4 en eet Cee: aLecaccetcee Z<_ole What amount will be given for aid to child’s support? Where and when did father die? Give full address of guardian or parent. yrs as Roe Z ‘ ALA, LPPTL ST s Zz State fully reasons why child is dependent PA oe . a Pea All the above is absolutely true, to my best knowledge and belief. — ae Sign ae Ss PS 1. Only the guardian, officer or parent knowing the facts should sign this application. i a ae ae a AP 28 2. Parent, estate, guardian, relatives, should aid in the support of child if possible; living parent, especiflly the father, 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., S.