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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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Ayuylication for Adimnission Orphan Asylum Situated in Date of Application,.. Name in full of child or children. lP patty Z Place and date of birth. Ler } te EES ' g £2 4, L Peg helaad e ee on A WV yA Father’s and mother’s —> 5 Ca V COnattace.eLehtate YA ee IS, LILAL Lu V FOZT Where is parents’ marriage certificate va bat 1? Oe ae latelfle “2 a in ee When did parents come to California? 5 J ttetrep Ppa Behl May obecd. ld, 6. Where does living parent =—) (Give town, bigs and number.) Ps a IY, Laced. Lewis ah bed, If fathers living give occupation. 2D ) Where and when did father die? Sf ned A cls é fe fae LE Where and when did mother die? Art Atagd’ Is there any estate or life insurance? Jt What amount will be given ai aid to child’s support? Give full address of gtiardian or parent. WEA /ite2 (<2 io 2 fe gt State fully reasons why child is dependent 9 a. All the above is absolutely true, to my best knowledge and belief. Sign “ey Only the guardian, officer or parent knowing the facts shguld sign this application 2. Parent, estate, guardian, relatives, should aid in the support of child if possible; living parent. especially the father, i to pay for maintenance of child. < expected by the State State Board of Examiners, Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A. CARLISLE & Co., 8. F.