Case 940

Application for the Admission of a Girl

1. Give the girls's christian name and surname

E

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

Unknown about 13

3. Is she legitimate?

4. If baptized, state place and date of baptism

5. Are her parents living?

Mother living - Father unknown

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

Mother unknown

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

Mother 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.

Vagrant

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

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

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS