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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
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Application for Admission
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i Fae Orphan Asylum YA
Situated in 42-7422 A La
Date of Application.,.......G« Lege > Ee 197 2
Name in full of child or children,_
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Place and date of birth.
Father’s and mother’s name.
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4. Where is parents’ marriage certificate recorded?
When did parents come to California?
6. Where does living parent reside? (Give town, street and number.)
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If father is living give occupation.
Where and when did father die?
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8. Where and when did mother die?
9. Is there any estate or life insurance?
What amount will be given for aid to child’s support?
Give full address of guardian or parent.
State fully reasons why child is dependent
All the above is absolutely true, to my best knowledge and belief
Sign
Only the lian, officer or parent knowing the facts should sign this applicat
Parent, uardian, 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. CARLISLE & Co., 5. F-