Case 9146

Application for the Admission of a child

1. Give the child's christian name and surname

T

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

8 yrs.

3. Legitimate?

illegitimate

4. If baptized, state place and date of baptism

Yes at St. Luke's Chesterton, Cambridge 30 Nov. '2

5. Parents living?

no

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

not known (cause & date)

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

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

E

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.

House keeper

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

none

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

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

R, Tusbury Burton-on-Trent, not known