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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 602 Collections and/or Records:

Dave Yudelowitz's Application for Admission to JCRS, 1906 March 9

 Item
Identifier: B002.01.0102.0119.00001
Overview Application form of Dave Yudelowitz for admission as a patient to the Jewish Consumptives' Relief Society. He was age 50 at the time of the application. He was born in Russia and immigrated to the United States in 1897. He lived in New York when he contracted tuberculosis. He had been sick for 4 years upon arrival to Denver, Colorado. He was married and had two children. He also worked as a presser. He was in Denver County Hospital for one week before applying for JCRS. The verso of the...
Dates: 1906 March 9

Dave Yudelowitz's Application for Admission to JCRS, 1908 March 3

 Item
Identifier: B002.01.0102.0119.00004
Overview Application form of Dave Yudelowitz for admission as a patient to the Jewish Consumptives' Relief Society. He was age 50 at the time of this application. He was born in Russia and immigrated to the United States in 1897. He lived in New York when he contracted tuberculosis. He had been sick for 5 years upon arrival to Denver, Colorado. He was married and had two children. He also worked as a presser. He was in Metropolitan Hospital, New York City before applying for JCRS. The verso of the...
Dates: 1908 March 3

Dave Yudelowitz's Application for Admission to JCRS, 1910 April 15

 Item
Identifier: B002.01.0102.0119.00011
Overview Application form of Dave Yudelowitz for admission as a patient to the Jewish Consumptives' Relief Society. He was age 56 at the time of this application. He was born in Russia and immigrated to the United States seven years ago. He lived in Detroit, Michigan when he contracted tuberculosis. He had been sick for 2 years upon arrival to Denver, Colorado. He was married. He also worked as a peddler. The verso of the application states he was admitted as an emergency patient on April 19, 1910 and...
Dates: 1910 April 15

David Fainberg's Application for Admittance to JCRS, 1911 January 09

 Item
Identifier: B002.01.0103.0137.00001
Overview David Fainberg's handwritten application for admittance to JCRS. Includes information such as age (27), place of birth (Romania), and occupation (tailor). He was a widow and had one child, and his nearest relative was his father, Herman Fainberg, in Pittsburg. On the backside it reads he was admitted on January 26, 1911, and discharged on October 31, 1912.
Dates: 1911 January 09

David Gordon's Application for Admission to JCRS, 1911 September 13

 Item
Identifier: B002.01.0104.0152.00001
Overview Application form of David Gordon for admission as a patient to the Jewish Consumptives' Relief Society. He was age 43 at the time of the application. He was born in Romania and immigrated to the United States in 1904. He lived in Port Chester, New York when he contracted tuberculosis. He had been sick for one year upon his arrival to Denver, Colorado. He was married and had four children. His occupation states he worked as an agent. The verso of the application states he was admitted on October...
Dates: 1911 September 13

David Gordon's Application for Admittance to JCRS, 1909 March 18

 Item
Identifier: B002.01.0101.0034.00001
Overview Application for admittance to JCRS filled out by hand in ink for David Gordon. Information on the form includes his age, place of birth, occupation, residence, marital status, children's ages, previous stays at hospitals, nearest relatives, and is signed by David Gordon. At the bottom of the page is a section entitled "Recommendation" which is left blank. The back of the form has a section entitled "Report of the Medical Examiner," which states the exam took place March 20, 1909 and found the...
Dates: 1909 March 18

David Gottdank's Application for Admittance to JCRS, 1909 April 26

 Item
Identifier: B002.01.0101.0050.00001
Overview Application for admittance to JCRS filled out by hand in ink for David Gottdank. Information on the form includes his age, place of birth, occupation, residence, marital status, children's ages, previous hospital stays, membership to beneficial societies or lodges, nearest relatives, and signed by David Gottdank. At the bottom of the page is a section entitled "Recommendation" which is left blank. The back of the form has section entitled "Report of Medical Examiner," which states that the...
Dates: 1909 April 26

David Grossman's Application for Admittance to JCRS, 1910 August 5-1910 September 12

 Item
Identifier: B002.01.0103.0027.00001
Overview JCRS Application filled out by hand in ink for David Grossman. Information on the form includes his age, birth place, occupation, residence, marital status, nearest relatives, previous hospital stays and signed by David Grossman. At the bottom of the page is a section entitled "Recommendation," which is left blank. The back of the form has a section called "Report of Medical Examiner" which is left blank. The middle section of the back is a form filled out by hand in ink. It reads "Application...
Dates: 1910 August 5-1910 September 12

David Melnicoff's Application for Admittance to JCRS, 1909 December 10

 Item
Identifier: B002.01.0102.0041.00001
Overview Handwritten application for admittance to the JCRS in pen for David Melnicoff. It includes his age (21), place of birth (Russia), and his occupation (button hole maker). His closest relative is his father, Leon Melnicoff. It is written on the back side he was admitted on May 18, 1910, and left on February 04, 1911.
Dates: 1909 December 10

David Rubin's Application for Admission to JCRS, 1910 March 18

 Item
Identifier: B002.01.0102.0098.00001
Overview Application form of David Rubin for admission as a patient to the Jewish Consumptives' Relief Society. He was age 41 at the time of the application. His place of birth states he is from Berdichev, Russia and immigrated to the U.S. in 1905. He lived in St. Louis, Missouri for five years where he contracted tuberculosis. He was also married and had seven children. He belonged to King of David Lodge of the Progressive Order of the West. The verso of the application is blank.
Dates: 1910 March 18