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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
ou, f Ayplication for Admission
TO
Orphan Asaylium
Situated in
Date of Application,
1. Name in full of child or children.
Ie e/ Le CTE
he Mee
Place and date of birth.
ee
Father’s and mother’s name,
7
atte ey
Where is parents’ marriage certificate recorded?
A PERAA LEP
When did parents come to California?
Where does living parent reside? (Give town, street and number.)
/ ¥ 8: 7 Z
pea 22 oF 7 tz Yaz Ktt/
If father is living give occupation.
Where and when did father die?
and when did mother die?
4
Is there any estate or life insurance?
att) th ame
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
oe ee
— Apprrd
All the above is absolutely true, to my best knowledge and belief.
Sign
1. Only the guardi , arent knowing the facts should sign this application. ;
2, Parent, estate, gu "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, Caruisie & Co., 8. F.