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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 tor Admission
a
Orphan Asulum
Situated in SPELL LLL
Date of Application, Leeerth LIO€
Name in full of child or children.
_Arace Srcyfies
KLlet, Lohse
Kecrcbatot
Where is parent’s marriage certificate recorded ?
Sectc hea
Place and date of birth.
Father’s and mother’s name.
When did parents come to California ?
Where does living parent reside? (Give town, street and number.)
Where and when did father die ?
a (oe7 Zz
Orr 30 ae.
Is there any estate or life insurance ?
When did mother die ?
ded
What amount will be given for aid to child’s support ?
Give full address of guardian or parent.
dr Klo-cheWe ww whfpot Lurcha
All the above is absolutely true, to my best knowledge and belief.
)
\
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
Form No. 346—APPLICATION FOR ADMISSION TO ORPHAN ASYLUM. A CARLISLE & Co., 417 Montgomery St., S. F