Case 3303

Application for the Admission of a child

1. Give the child's christian name and surname

G

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

5 years Gladstone St. Heanor December 31, 1887

3. Legitimate?

yes

4. If baptized, state place and date of baptism

Yes May 18th 1892, Heanor Christ Church

5. Parents living?

not living

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

Mother murdered Dec. 8th, 1891 by husband
Father suicide Dec. 8th, 1891

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 his parents (in full) and state their ages.

Mother A, 31
Father C, 32

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.

Brickmaker - about 24/- per week. Charles Fidler of Nelson St. Heanor (deceased)

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.

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

no

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

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

[?], Derby Rd. Heanor, 11, goes to school, none
[?], ", 9, ", "
E, ", 7, ", "
G