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Application forms

 Subject
Subject Source: Art & Architecture Thesaurus
Scope Note: Forms used by persons requesting assistance, authorization, employment, admission, or other action.

Found in 10 Collections and/or Records:

Ben Belovsky's Application for Admittance to JCRS, 1909 February 15

 Item
Identifier: B002.01.0101.0020.00001
Overview Application for admittance to JCRS filled out by hand in ink for Ben Belovsky. Information on the form includes his name, age, birthplace, occupation, residence, marital status, children's ages, nearest relatives, and signed in Yiddish by Ben Belovsky. Nearest relatives listed as Annie Nissman and Jennie Belovsky. At the bottom of the page, under "Recommendation," are two names and addresses. The recommendations were provided in Denver on the 17th of February 1909 and read "Emanuel Friedman,...

Ester Sayetta's Application for Admittance to JCRS, 1908 November 09

 Item
Identifier: B002.01.0100.0094.00001
Overview JCRS Application for Admittance filled out in ink for Patient #957 E. Sayetta "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado" dated "Nov 9th 1908" [sic]. The application includes patient's name, sex, age, occupation, residential information, medical information, marital status, number and ages of children, and nearest relatives or friends; "Sister Fannie Winsberg 55 Loyal Pl. Chicago Husband +children Louis Sayetta 1675 Elliot St." and the application...

Isaac Stoller's Application for Admittance to JCRS, 1908 January 21

 Item
Identifier: B002.01.0100.0095.00002
Overview JCRS Application for Admittance filled out in ink for Patient #958 I. Stoller "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado" dated "Jan 21, 1908" [sic]. The application includes patient's name, sex, age, place of birth, occupation, residential information, medical information, marital status, number and ages of children, and nearest relatives or friends; "Wife Sophie Stoller 238 Clinton St New York - Cousin [M.] Philips 8 North Front Baltimore Md"...

J. Bilovsky's 1st Application for Admittance to JCRS, 1908 January 10

 Item
Identifier: B002.01.0100.0091.00002
Overview 1st JCRS Application for Admittance filled out in ink for Patient #951 J. Bilovsky "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado...Received January 10 1908" [sic]. The application includes patient's name, sex, age, occupation, residential information, medical information, marital status [single], number and ages of children [none], and nearest relatives or friends; "(sister) Mrs. Annie Neshman 89 Johnson Av. Bklyn" and the application is signed Jacob...

J. Bilovsky's 2nd Application for Admittance to JCRS, 1908 October 28

 Item
Identifier: B002.01.0100.0091.00001
Overview 2nd JCRS Application for Admittance filled out in ink for Patient #951 J. Bilovsky "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado" dated "Oct 28 1908" [sic]. The application includes patient's name, sex, age, citizenship, occupation, residential information, medical information, marital status [single], number and ages of children [none], and nearest relatives or friends; "Sister Annie Bilovsky 156 [illegible] St. Brooklyn. Brother B Belovsky 804...

Jacob Katz's Application for Admittance to JCRS, 1909 May 10

 Item
Identifier: B002.01.0101.0058.00001
Overview Application for admittance to JCRS filled out by hand in ink for Jacob Katz. Information on the form includes his age, place of birth, occupation, residence, marital status, children's ages, nearest relatives, and signed in black ink by Jacob Katz. At the bottom of the page, under "Recommendation" are two names and addresses. The first reads "Louis Schapiro, 2709 W. Colfax," and the second reads "Max B. Goldberg, 2640 West Colfax." The back of the form has section entitled "Report of Medical...

Lena Greenberg's Application for Admission to JCRS, 1909 April 27

 Item
Identifier: B002.01.0101.0049.00001
Overview Application for admittance to JCRS filled out by hand in ink for Lena Greenberg. Information on the form includes her age, place of birth, occupation, residence, marital status, children's ages, membership to beneficial societies or lodges, nearest relatives, and signed "Lena Greenber" by her husband. At the bottom of the page, under "Recommendation" are two names and addresses. The first reads "Louis Schapiro, 2709 W. Colfax Ave." The second reads "Robin Halpern, 1516 Boulevard F." The back of...

Louis Wolf's Application for Admittance to JCRS, 1909 March 6

 Item
Identifier: B002.01.0101.0030.00001
Overview Application for admittance to JCRS filled out by hand in ink for Louis Wolf. Information on the form includes his age, place of birth, occupation, residence, marital status, previous stays in a Sanatorium or Hospital, nearest relatives, and is signed by Louis Wolf. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "M. Feldman, 1527 Dale Court." The second reads "S. Z. [Illegible], 2793 W. Colfax Ave." The back of the form has a section entitled...

Minnie Greenberg's Application for Admittance to JCRS, 1909 May 3

 Item
Identifier: B002.01.0101.0051.00001
Overview Application for admittance to JCRS filled out by hand in ink for Minnie Greenberg. Information on the form includes her age, place of birth, occupation, residence, marital status, previous hospital stays, nearest relatives, and signed by Minnie Greenberg. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "Louis Schapiro, Address 2709 W Colfax Ave." The second reads "E. Freidman, Address 2760 [illegible] Ave." The back of the form has section...

Sarah Pitchinoc's Application for Admittance to JCRS, 1908 November 12

 Item
Identifier: B002.01.0100.0098.00001
Overview JCRS Application for Admittance filled out in ink for Patient #963 S. Pitchinoc "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado" dated "Nov 12, 1908" [sic]. The application includes patient's name, gender, age, place of birth, citizenship, occupation, residential information, medical information, marital status, number and ages of children, and nearest relatives or friends; "Mrs Rosie Green [Greene] 408 Van Sekland [Sicklen] ave E. New York [and] Mr....