Case 9126

Application for the Admission of a child

1. Give the child's christian name and surname

E

2. State the exact age, and give the date and place of birth

10 years & 9 months, Eleanor St. Fulham, Sep. 14, 1891

3. Legitimate?

yes

4. If baptized, state place and date of baptism

At Baustead School at 3 yrs. of age

5. Parents living?

Father & mother

6. If, however, either or both are dead, state of what disease they died and give the date of their death

7. If living, give their exact places of abode, and state how long they have resided there

Father has been in Hanwell Lunatic Asylum for 9 years. The mother lives at West Pembroke Place, Kensington for the last 7 weeks & previously in Kensington place for 9 months, is a native of Kensington

8. Give the christian names and surnames of the parents (in full) and state their ages

R, aged 49
E, aged 49

9. What was or is the nature of the father's occupation and the amount of his weekly earnings? Give the name and address of his present or last employer.

10. What was or is the nature of the mother's occupation and the amount of her weekly earnings? Give the name and address of her present or last employer.

Charring on an average earns 9/- a week Town Hall, Kensington, Mrs Chapman

11. Have the parents or guardians ever received parish relief? If so, to what extent?

The mother a little assistance, at the time of her confinement

12. Give the names, addresses, ages, occupations and earnings (if any) of all the brothers and sisters

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

A, Peel St. Kensington, 21, porter, 18/-
G, Edge St., Kensington, 19, porter, 12/-
R, [?] Pembroke Place, 16, Labourer, uncertain
I, [?]Boys School Richmond, [?]