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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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Appliration for Admission to Ph y (Pull Nan of Institution) Lt eds Ste ented needed U My, Pltcada Co) CatIn the matter of the application os tt, LUE. OLb OAL. for the admission of.. PAYY. child tt1<~.to this institution ae ation is hereby made for the admission to.«<Z LOY Ae Ley, Ofelia ti Kyte Full Name oa Le ”n of. LAYE..child 44aZ, and in support thereof the following statements are qiieateiet. Number 4 Jf AGE 1. Name of child 7A4/ pleat Years . Mont Sex. Place and Date of Birth Family Name¢ Given N id er li (b is Vyplecs aw Sa “ (c) re Mtl Ot pe ze _ 2 (d 5 eas 3 /0 Jn i 4! OF. 2. Status of chila A#tatDephan, Half Orphan Abesctomedt 3. Has parent or child/7¢a¢-<any estate, or are they or either of them heir to any estate? If so, deseribe said estate, its location and value, including insurance, if any. ) ZG6 A, 4. Haacr..the child Atax..ever been legally adopted? If so, by whom?... tt parse! 5. Father’s name...tK422uL4 LLl Pe Sn .. Nativity oe 3 PELO TL. Magne: Place and date of de uth Le CML POG : ve ; I 6. Mother’s name.cZ Velen : “3B hoe le J 4L .. Nativity . (i ee Place and date of death Me Ack Lik le ae Zi Lter; ih Oh, AM. Vee LSS 7. When and where were parents married ?... LAA ae 6 VA » ree LABEL CE AE 8. Where is marriage certificate recorded? at rd 9. Date father came to California? ei, 17/02 Mother? (Hay /F10%0 County, 7 7.77% 0. Which parent is living? Sa Z AEX Habits of sobriety? SLervl. 1. Residence of wonones 4a pane Occupation? “~—# 27 ce 2. Relation of applicant to child 2 G2: 6 13. Full address of guardian or parent?.. [email protected] CA . Cr ee Les 4d b Vy tl er Loft 4, A 4veu.the child/A414™..inmate of an institution? LEO 5. Name and address of institution ?. 6. What amount will be given for aid of child. ? $..00. UC per year. By whom?..= than ONI child « of one fa 2 xd of Orph an id forwar but not for children of different families ed at once to Secretary of Board of Control, Sacramento, California, pplication may 3 application must For N 5—APPLICATION OR ADMISSION TO INSTITUTION A. Carlisle & Co., 8, F.