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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
Application for Adinission
TO
CEZZ Orphan Asylum
a
Situated in ‘ Ziaay Pea
Date of Application, tire : s
Name in full of child or children.
Place and date of birth.
S Lobt27 ., Ve
7)
Father’s and mother’s name. : ee .
Pia Zot
ie ;
When did parents come to California?
AZo
Where does living parent reside? (Give town, street and number.)
Where and when did father die?
Vi
Ez
y
When did mother die?
Is there any estate or life insurance?
)
What amount will be given for aid to child’s support?
IP4t23 ay y Atos A fo: 52 ft
% 7
22th
Give full address of guardian or parent.
All the above is absolutely true, to my best knowledge and belief.
Signe La
Only the iar i : parent knowing the facts should sign this application.
Parent ‘an, relatives, should aid in the support of child if possible: hving parent, especially the father, is expected by the
State to pay for ms ,ance of child.
’
Form No. 346--APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Caruiste & Co., 8. F.