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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 Adinissinn
TO
Ly
. Orphan Asylum
Situated in
Place and date of birth.
Father’s and mother’s name.
4
& (2 P , p. LY
Where is parents’ marriage certificate regorded?
When did parents come to/California?
Where does living parent reside? (Give town, street and natmber.)
If father is living give occupation.
Where and when did father die?
Where and when did mother die?
ye
Is there any estate or life insurance?
b pss amount will be given for aid to child’s support?
CA
Give full address of guardian or parent.
ff
a 1 fi, fr.
State fully reasons,why child is dependent, CECH L;
All the above is absolutely true, to my best knowledge and belief.
sign £274
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. Caruiste & Co., S. F’