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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
Application for Admission
AKG)
Name in full of child or children.
Place and date of birth,
Father’s and mother’s name.
Dos eg LEB
Where is parents’ marriagé certificate recorded ?
7 t
When did parents come to Cz yes ?
AS toe 2
Where does living ps or reside? (Give town, street and number.)
(Dre
f father is living give occupation.
Where and when did fs Sap g die 2
A EL C. a Le
Where and when did mother die ?
Street ere
Is there any estate or life insurance ?
L5
Vogtle y,
What amount will be given oy aid to child’ s support 1¢
t
Give full address of guardian or parent.
12. State ful ly reasons oor child is de oa Sa Fee as a7 thie: aie: A0EO7 Lett,
All the above is absolutely true, to my best knowledge and belief.
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
to pay for maintenance ‘of child.
State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Canuiste & Co., 8. F.