Case 8473

Application for the Admission of a child

1. Give the child's christian name and surname

J

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

September 28th 1892 Cannock Workhouse. The Workhouse Cannock

3. Legitimate?

yes

4. If baptized, state place and date of baptism

Baptized on or about Oct. 5, 1892 at workhouse (Cannock)

5. Parents living?

Mother living, Father not known, been missing for 9 years

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 is domestic servant at Coven Vicarage W. Hampton

8. Give the christian names and surnames of his parents (in full)

[?], S

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.

Coal-miner works at East Cannock before deserting his wife

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.

Domestic service £10 per annum, Mrs. R Coven Vicarage Wolverhampton

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

Yes the mother in the workhouse

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

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS