Case 866

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

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 her relatives are in your judgment in a position to maintain him, or to contribute in any degree to his support.

16. Has she ever been convicted? Is so, state the nature of his offence and term of imprisonment.

17. Has she ever attended day school? If so, where and for how long?

18. Has she ever attended Sunday School? Is so, where and for how long?

19. Has she ever been in the workhouse? If so, for how long and where?

20. Has she any affections of the limbs, joints, skin or eyes which may have the affect of preventing him from entering domestic services?

21. Is she subject to fits? or has he ever had one? If so, state its nature. Is this child subject to incontinence of urine?

22. Is she at present affected with any infectious or contagious disease, or with scrofula requiring medical treatment?

23. Has she had scarlet fever, or whooping cough or measles, orsmall pox? If not the latter, has she been vaccinated?

24. Is her general health good?

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

I certify that the foregoing questions have been correctly replied to.

Name B

Address S Andrews Vicarage

Incumbent of S Andrews Croydon

Date Dec 4 1886

Case 866

1. Application to Waifs and Strays' Society 4 December 1886

Original document


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