Case 9279

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 her birth

Born in Walsall Sept. 23rd 1890

3. Legitimate?

no

4. If baptized, state place and date of baptism

Yes in Walsall Workhouse

5. Parents living?

father dead mother in asylum

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

cannot say

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

Mother in [?] Asylum for 4 years

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

M

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.

general servant [Herwich] Rd. Walsall

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

at the child's birth

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

NAME, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

13. At what address and with whom is the child now living?

at Whitehouse St. Whall - with grandmother

14. Give in full the names, addresses, ages, occupations and earnings of each living relative the child is known to possess either on the father's or mother's side such as grandparents, uncles, aunts, &c.

DEGREE OF RELATIONSHIP, NAMES, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

Grandmother, A, Whitehouse St., 73, widow, owing to death of the [?] will have to [?] for Parish [?]