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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 Admission
TO
Orphan
Asulum
Sitwated in
Date of Application,
Name in full of child or children.
,
eed
Place and date of birth.
Father’s and mother’s name.
SF, Paes
Of ALLA
4. Where is parent’s marriage certificate recorded ?
When did parents come to California ?
7 ,
“
LRP
6. Where does living parent reside? (Give town, street and number.)
Min’ Lao Gantate.o Lak Fale dy
Where and when did father die ?
When did mother die ?
q
AL
é
All the above is absolutely true, to my best knowledge and belief.
Sign YW, fC Chick,
1. Only the guardian, officer or parent knowing the facts should sign this application. x
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