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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
Ayplication for Admission
Date of Application,
Name in full of child or children.
Place and date of birth.
Where is parents’ marriage certificate recorded?
When did parents come to California?
SEES
Where does living parent reside? (Give town, street and number.)
ee
If father is living give occupation.
Where and when did father die?
Where and when did mother die?
Is there any estate or life insurance?
What amount will be given for aid to child’s support?
Give full ahi of guardian or parent.
4
State fully reasons why child is daha caw, Ltt ion DB
Se PHtk) y Le FiC?: Laie hea (7?
All the above is absolutely true, to my best knowledge and belief.
ofc
ian, officer or parent knowing the facts sisal siga this ee ‘ation.
€, guardian, relatives, should aid in the support of child if possible; living
to pay for maintenance of child. % parent, especially the father, is expected by the State
State Board of Examiners, Form No. 346 APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Caruiste & Co., S, F’