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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 Orphan Asylum eS Situated in ght LL Tip 4 Date of Application, A) BE iS, red 1. Name in full of child or children. me . Place and date of birth. ML. Ck ctecl, ve cutie bead wt > hat PLES Ye 39 fees, hp OA we dL Ftd Mleannnt, puaen /t-190 b, hiked, yan 4 1705 Father’s and mother’s name. (7 et os Where is ML marriage eens ite recorded? When did parents come to California? 6. Where does living parent reside? (Give town, street and number.) Aacle, Mak... fo LY Ad, ia LANL URN Oaks If father is living give occupation. a yy ae and Si did cays die? _ ee Mg” Mika? LAE 8. Where and when did mother die? 9. Is there any estate or life insurance? LL es ZLE 10. What amount will be given for aid to child’s support? Nigres 11. Give full address of guar 2 or parent. f) Cava Lenipaliay. Li 22, lly, LEKUEY MAO Le 12. State fully reasons“why child is dependent by LULU Heed ts tthe aad oes Le Jithher f1. Only the guardian, officer or parent knowing the facts should sig, is applica < Sy 2. Parent, estate, guardiz an, relatives, should aid in the support of €bxd if possible living My the fatkér, is expected by the State to pay for maintenance of child. fi ZL State Board of Examiners, Form No, 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. CarRLIste & Co., S. F”