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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 50 i, a Crntet/ WY Adhd Orphan Asylum Situated in 2a V hls Date of Application,... AlIA—-..A.0. Name in full of child or children. [7/ earn ore (2) Z, eo ie @ Bogs ‘$) hackle € , te 2. a and ee, Mer themed, am Dod ty. Pgafganct rid)... Lieey,., 27, F402 a Vix Do “ “ Mee, Az , C904 3. Father’s and mother’s name. 4. Where is parents’ marriage certificate recorded? Jicareyenetlc“ 5. When did farents come to California? ’ rd 4 /6. Where does living oe a (Give town, street and number.) If father is bona give occupation. Co 2st Where and when did father die? Where and when did mother die? 2 Cb vee oa Hare Ze peo 7 fat Is there any estate or life insurance? Jlasel. What amount will be given for aid to child’s support? Give full gpg of guardian or qe tnd, y, oo WES. NI ate aii ZA Jehze Leal : 12. State fully reasons why child 4% dependent ease Acad «puch ee Ad puffed! ote 2. he ae 0. CL Vd me Z eae od i sole aes Pd oe ae fart feta 2aetk All the above is absolutely true, to my best knowledge and belief. az Vj 1. Only the guardian, officer or parent knowing the facts should sign this application 2. Parent, estate, giardian, relatives, should aid in the support of child if possible: living parent.. especially the faiher, iz 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.