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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 TO a) biatley Orphan Asylinn y) Situated in Yr ath! aa Date of Application, Ze aos gt Wi) Name in full of child or children. vA /) 4 S Place and date of birth. VEZ, VEZ Meg. a Father’s and mother’s name. cay aa ’ When did parents coffe to California ? Where does living parent reside? (Giye town, street_and number.) Se tas, Lark. \hilb. Oe? ede eb If father is living give o¢fupation. y, {/ Where and when did father die? _ CA berdl tint Peed? iia Ltt, LOGE, Where and when did mother die ? Is there any estate or life insurance ? ACo27t What amount will be given for aid to child’s support ? vd Give full address of guardian or parenj/ ; J Mary 7. aA tittle State fully reaséhs why as is dependent Sis 7. re g AL G é a WU fy Re Qe? Lavireg. Kg CH tz ey Ee CAttel vt, All the above is absolutely true, to my best knowledge and belief. Sign... La! 44 LAM, 7 1. Only the guardian, officer or parent knowing the facts should sign this applicationé 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 y for maintenance of child. State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. Caruiste & Co., 8. F.