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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 HG) 20 a CL a Za Orphan Asylum Situated in Name in full of child or children. Place and date of birth. AE <2. (ag va : SP OL Father’s and mother’s name. Z : CB. A272 lt Qe A pA SS oom saben mea: a LF: Qt a Le GPT : Where is parents’ marriage certificate recorded? ' A When did parents come to California? Miuwl * SP Ie eae ee (fn ae Where does living parent reside? (Give town, street and number.) Fete : ar G conten! 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? 4 What amount will be given for aid to child’s support? ( Give full address of guardian or parent. a Pea ees Jeo. 7 he 18 AA le yy € canes (Y, ak State fully reasons why child is ppp er x gf PEO ra a ies cad ae c: All the above is absolutely true, to my best knowledge and belief. LZ 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 I I A to pay for maintenance of child. State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. CaruisLte & Co., S. F*