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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 = TO mace aA aerYirlteey~.w ~ Orphan Asylum Situated in Lrecefiattyy Date of Application, ae G& 19 Gr 7 F Name in full of child or children. if ZZ t Vtler Md Place and date of birth. a Poe. Where is parents’ marriage eettificate recorded? When did parents come to California? Vie ae Where does living parent reside? (Give town street and number.) If father is living give occupation. Where and when did father die? Where and when did mother die? Le . é 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 SL y e a All the above is absolutely true, to my best knowledge and belief. 1. Only the guardian, officer or parent knowing the facts should sign this application. é é i 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. Caruisuz & Co., 8. F.