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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 GraceV/2 Orphan Asylum Situated in ies V2Clheg Colayorrecee Date of Application rf PEBLLL Pd ee Vie Name in full of child or children. Zz, ee e o, SS , ia BAATL Aff ZOE Place and date of birth. Pray laa /240— Father’s and mother’s a (pom je DE. pL Where is parents’ marriage certificate recorded? One . YIP When did parents come to California? Where does living ae (Give town, street and number.) 4 : oLeBt On4e a (Q Ozl, If father is living give occupation. ocz Where and when did father die? ae Where and when did mother die? vA Drarch 22 190H . Is there any estate or life insurance? Doo What amount will be given for aid to child’s support? po Ved yr Oe ee <a Give full address of guardian or parent. » an ff State fully reasons why child is dependent ee ok be ees sft He 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. " 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. Caruiste & Co., S. F.