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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 EO Situated in VA yp, = Date of Application, He fag Ae 19 22 Name in full of child or children. é ii . Akai fata Name tc se Oe eee ere “er a OF Ln, { Ch Or. ET big 4 a SEN OY lt i eX } : asiok Oty 0 Op Place and date of birth. Reco 2 on (nent ty J. enagta IB ons. (Gee Ee ee me pty biota tc Pee Perec eG ae. Le ae 7 Loy OM. APL tpt bOne Ad; eS, Manca Ont 2) Father’s and mother’s name. we Vb. Cabos, pth 1d. Khe whe Aw 07 ke ae eee a Vegi oo Where is parents’ marriage certificate recorded? me a )‘ LL LX tg When did parents come to California? B74 6. Where does living parent reside? (Give town, street and number.) rf LA (oy 5 C Pts If father is living give occupation. Where and when did father die? ‘3 g. EEL oy 8. Where and when did mother die? 9. Is there any estate or life insurance? LLa10. What amount will be given for aid to child’s support? M ge Ps ee, fro é 11. Give full address of guardian or parent. ; ; 4 q a and. dSe eg 9 —Treangead Bon.. Coren Lt Besimot Ava 12. State fully reasons why child is dependent All the above is absolutely true, to my best knowledge and belief. sin.. and. meray 1. Only the guardian, officer or parent knowing the facts should sign this application. 2. Parent, estate rdian, relatives, should aid in the support of child if possible; living parent, especially the father, is pomre ¢ by the State to pay for maintenance of child. State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Caruiste & Co., S.