Case 6380

13. At what address and with whom is the child now living?

Spekeland Grove - with his mother

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

M. Grandmother, Mrs. (Wid), Fletcher St., ?48, Charwoman, 6/s
Step-Uncle, W, 35 Shallot St., 28, Warehouseman, ?
", J, Fletcher St., 18, nil
", J, ", 16, Errand boy, 6/-
", P, ", 12
Husband's sister, Mrs., ? Everton, 18/-
Husband's brother, J, ?, 45

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 toward its support?

none

16. Can any payment for the child be guaranteed from any source?

none

17. Has the child ever been convicted? Is so, state the nature of the child's offence and term of imprisonment

/

18. Has it ever attended day school? If so, where and for how long and in what Standard is it?

S. Bride's Grey St. about a year Chatsworth St. Board - 4 months II Inf.

19. Ever attended Sunday School? Is so, where and for how long?

S. Bride's 2 yrs.

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 him from entering domestic services?

no

22. Is the child subject to fits or has the child ever had one? If so, state its nature. Is this 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 he been vaccinated?

Yes both children have had measles, and both are vaccinated

25. Is the child's general health good?

yes

26. Are the child's parents, grandparents or next of kin, willing to sign an agreement to commit the boy wholly to the care of the Managers of the Home, to obey the rules in force, and to permit the said boy when fully trained to be sent to any situation in the United Kingdom which may be obtained for him by the Managers?

Would like more information

I certify that the foregoing questions have been correctly replied to by who is known to me as a responsible person.

Name

Address

Incumbent of

Date

Cross written in pencil: Own handwriting, at mother's dictation R