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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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Ayylication for Admission LO GraecV alley — Orphan Asylim Situated in. Creel a ctecy, Date of Application, ....<7 Ly 4B, 1. Name in full of child or children. 2. Place and date of birth. t ; es 422 Lot. eee lee ce Cze 4 DAPPER) fs Le et AM 2 OO) Oe 3. Father’s and mother’s name. ’ Zecca Sg ees Z2ZE2et —<2see2 — Where is parents’ marriage certificate recorded? ‘ When did parents come to California? ctacete eh) tee. RES «Grace a pert Nene, Where does living parent reside? (Give town, street and number.) If father is living give occupation. Where ae when did father re. rojeniaea'\e wea and w oe did mother die? Pe Sy 5 a Is there any estate or life insurance? ae Jpeg ea eh : What amount will be given for aid to child’s support? Ut Ab? Give full address of guardian or pgrent. 2 2 Fy oo y OF ety A R2-EE DORA, ree State fully ae Ze child is a ae Ae Chit ae a Fe] the EAL, 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. 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. Caruisue & Co., S. F.