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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 Admission LO Beret atiecy Orphan Asylum Sttuated in Date of Application, Name in full of child or children. ( amt Place and date of birth. fy vA A SA han ~ / Father’s and mother’s name. __Where is parents’ marriage certificate recorded? & feet Mheep2 o— ifornia? Where does living parent reside? (Give town, street and number.) y If father is living give occupation. Where and when did father die? Lee BAI 4 Where and when did mother die? Ss Cae Is there any estate or life insurance? What amount will be given for aid to child’s support? Give full address of guardian or parent. State fully reasons why child is dependent All the above is absolutely true, to my best knowledge and belief. Sign... 1, Only the guardian, officer or parent knowing the facts should sign this application. ‘ f 2. Parent, estate, guardian, relatives, should aid in the support of child if possible: living parent, especially 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. CaruisLe & Co., 8. F.