Hidden Lives Revealed. A virtual archive - children in care 1881-1981 * Image of handwritten text

Case 4776

1. Application to Waifs and Strays' Society 1 April 1895

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13. At what address and with whom is the child now living?
with H. [Ada] St. South Shields

14. Give in full the names, addresses, ages, occupations and earnings of each living relative the child is known to possess either on the father's or mother's side such as grandparents, uncles, aunts, &c.
DEGREE OF RELATIONSHIP, NAMES, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

15. State whether any of the child's relatives are in your judgment in a position to maintain the child, or to contribute in any degree to its support.
The oldest brother would be willing to contribute Five Pounds, per annum which is the most he is in a position to do.

16.Can any payment for the child be guaranteed from any source? If so, by whom?
No

17. Has the child ever been convicted? Is so, state the nature of the child's offence and term of imprisonment.
No

18. Has it ever attended day school? If so, where and for how long and in what Standard is it?
No

19. Ever attended Sunday School? Is so, where and for how long?
No

20. Has the child ever been in the workhouse? If so, for how long and where?
No

21. Has the child any affections of the limbs, joints, skin or eyes which may have the affect of preventing her from entering domestic services?
No

22. Is the child subject to fits or has she ever had one? If so, state its nature. Is the child subject to incontinence of urine?
No

23. Is the child at present affected with any infectious or contagious disease, or with scrofula requiring medical treatment?
No

24. Has the child had scarlet fever, or whooping cough or measles, or small pox? If not the latter, has it been vaccinated?
No. Vaccinated

25. Is the child's general health good, and has it average mental capacity?
Yes

26. Are the child's parents, grandparents or next of kin, willing to sign an agreement to commit it wholly to the care of the Managers of the Home, to obey the rules in force, and to permit the said child when fully trained to be sent to any situation in the United Kingdom which may be obtained for it by the Committee?
Eldest brother hopes to be in a position to provide for him entirely, when he has attained she age of fourteen or fifteen

I certify that the foregoing questions have been replied to by H. who is known to me as a responsible person.
Name - W.
Address - Westoe Crescent
Curate of - St. Thomas' Westoe South Shields
Date - April 1st 1895

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Image of Case 4776 1. Application to Waifs and Strays' Society  1 April 1895
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