Case 67

Dear

In reply to your application for the admission of a Boy into the above name HOME, I beg to send you a list of questions on page 3 of this form, to which you will please annex the fullest possible replies. When the form is returned, the case will be carefully considered, and a decision sent to you without delay.

Before filling up the paper kindly note the following instructions.

(First) Obtain, if possible, all the information required from the most reliable sources. Do not rest satisfied merely with the relatives' statement as to their pecuniary position, but if possible institute independent inquiry from employers, neighbours, or others.

(Second) Write the answers clearly and distinctly, never permitting the relatives of the child to write on the Paper, but having obtained the necessary particulars from them or others, fill the same in yourself carefully.

(Third) In addition to the questions which are appended, will you kindly give on page 2 as complete a history of the boy and his parents as you are able to obtain, stating (1) your reasons for desiring his admission into the HOME, (2) the nature and extent of your acquaintance with him and his family, and (3) all other particulars which, although not specified in the accompanying questions, may be useful in arriving at a decision.

It should be distinctly understood that in the event of the child be admitted to the HOME his parents, next of kin, or legal guardians, will have to sign a legal form, surrendering him entirely to the care of the Director or Managers of the HOME, and pledging themselves under a money penalty, recoverable in a court of law, not to remove or otherwise interfere with him until the full term for which he is entered shall have expired.

For the sake of the boy on whose behalf application is made, and for the protection of the Committee, it is most important that no information should be withheld concerning the child's past history or that is likely to affect his future.

I am,
Yours faithfully,
E. de M. RUDOLF,
Hon. Secretary.