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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:

Dora Kaufer's Application for Admittance to JCRS, 1909 December 06

 Item
Identifier: B002.01.0102.0038.00001
Overview Handwritten application for admittance in pen to the JCRS of Dora Kaufer. Information include age (35), place of birth (Austria), and occupation (housewife). Her means of support is her husband, Geo Kaufer. On the back side it is written she is suffering from tuberculosis stage II, with infiltration on right lung. It also says she was admitted on December 23, 1909, and discharged on April 01, 1910.
Dates: 1909 December 06

Duplicate Application for Admittance to JCRS

 Item
Identifier: B002.01.0100.0021.00002
Overview Duplicate application for admittance to JCRS. Front of form is blank. Back of form is blank except for middle section which is filled out by hand in ink. It reads "Application No. 838 Case No. 590, Application of, Samuel Rappaport, Received July 10, 1908, Admitted Aug 12, 1908, Died Dec 1, 1909."
Dates: 1908-1916

Duplicate Application for Admittance to JCRS, 1909 December 01

 Item
Identifier: B002.01.0102.0035.00003
Overview A duplicate application of admittance to JCRS for Abraham Goldstein. The front side is blank, and the back side has handwritten information in pen about the day the application was received, December 1st 1909, the day he was admitted, May 17 1910, and the day he passed away, July 22, 1910. It also has his name and address written, and on "Remarks" it is written "original attached".
Dates: 1909 December 01

Duplicate Application for Admittance to JCRS, 1911 March 3

 Item
Identifier: B002.01.0103.0166.00002
Overview Handwritten application from Hyman Keller for admittance to JCRS. This is a duplicate of the original application as noted on the front page. Application contains information such as: age (28); occupation (printer); marital status (single); and place of birth (Russia). Backside of application indicates Keller has pulmonary tuberculosis stage II-III and it is in both lungs. Admitted to JCRS October 16, 1911 and discharged April 14, 1912.
Dates: 1911 March 3

Eli Smith's Application for Admittance to JCRS, 1909 May 21

 Item
Identifier: B002.01.0101.0073.00001
Overview Application for admittance to JCRS filled out by hand in ink for Eli Smith. Information on the form includes his age, birth place, occupation, residence, marital status, number of children, previous hospital stays, membership to beneficial societies or lodges, nearest relatives, and signed by Eli Smith. At the bottom of the page, under "Recommendation," are two names. First one reads "Nathan Yurofsky, 414 S. Broadway" and the second name is largely illegible but reads "A. [illegible], 1409...
Dates: 1909 May 21

Elias Berger's Application for Admittance to JCRS, 1908 July 20

 Item
Identifier: B002.01.0100.0027.00001
Overview Application for admittance to JCRS filled out by hand in ink for Elias Berger. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Elias Berger. The back of the form has section entitled "Report of Medical Examiner," which is dated July 20th, 1908. Next to stage reads "Incipient (?)." Next to "Remarks" reads "[illegible] changes apex R. evidence of past infection. After cough very fine [illegible]...
Dates: 1908 July 20

Elias Kantor's Application for Admission to JCRS, 1911 January 6

 Item
Identifier: B002.01.0103.0132.00001
Overview Application form of Elias Kantor for admission as a patient to the Jewish Consumptives' Relief Society. He was age 18 at the time of the application. He was born in Russia and immigrated to the United States in 1909. He lived in New York City before coming to Denver. He had been sick for five months upon arrival to Denver, Colorado. His occupation states he worked as a printer. The verso of the application states he was admitted on January 2, 1911 as an emergency patient, and died on February...
Dates: 1911 January 6

Elias Ring's Application for Admission to JCRS, 1910 November 14

 Item
Identifier: B002.01.0103.0101.00001
Overview Application form of Elias Ring for admission as a patient to the Jewish Consumptives' Relief Society. He was age 23 at the time of the application. He was born in Russia and immigrated to the United States in 1904. He lived in New York City when he contracted tuberculosis. He had been sick for three months upon his arrival to Denver, Colorado. He was married and had one child. His occupation states he worked as a peddler. The verso of the application states he was admitted on December 14, 1910...
Dates: 1910 November 14

Elias Secunda's Application for Admittance to JCRS, 1910 January 27

 Item
Identifier: B002.01.0102.0070.00001
Overview Handwritten application in pencil for admittance to the JCRS for Elias Secunda. It includes information such as age (34), place of birth (Russia), and occupation (bookkeeper). He was married and had five children, and his nearest relative was his wife, Jane. On the backside, it is written he had tuberculosis stage I, was admitted on May 10, 1910 and left on September 11, 1910.
Dates: 1910 January 27

Emanuel Sachin's Application for Admittance to JCRS, 1908 June 29

 Item
Identifier: B002.01.0104.0120.00001
Overview Emanuel Sachin's handwritten application for admittance to JCRS. Includes information such as age (36), place of birth (Hungary), and occupation (cigar maker). He was married and had one child, and his nearest relative was his brother-in-law in N.Y. On the backside it reads he was admitted on June 29, 1908, and left on November 4, 1908.
Dates: 1908 June 29