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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 600 Collections and/or Records:

Sam Millman's Application for Admittance to JCRS, 1907 August 20

 Item
Identifier: B002.01.0100.0082.00003
Overview JCRS application for admittance filled out in ink for Patient #938 Sam Millman "To the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado...Received August 20, 1907." The application includes patient's name, gender, age, citizenship, occupation, residential and medical history, and includes a relative's address: "Father, Morris Millman 718 S. 3rd St. Philadelphia, PA." The application is signed Sam Millman.

Sam Millman's Application for Admittance to JCRS, 1907 August 26

 Item
Identifier: B002.01.0099.0001.00001
Overview Application for admittance to JCRS filled out by hand for Sam Millman and dated August 26, 1907. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Sam Millman. The back of the form has sections titled "Report of Medical Examiner," which is dated August 26, 1907, and notes that Sam Millman entered the sanatorium for emergency care. The middle section of the back has "Application No. 564 and case No....

Sam Perlman's Application for Admittance to JCRS, 1909 February 18

 Item
Identifier: B002.01.0101.0022.00001
Overview Application for admittance to JCRS filled out by hand in ink for Sam Perlman. Information on the form includes his age, place of birth, occupation, residence, marital status, children's ages, nearest relatives, and is signed by Sam Perlman. At the bottom of the page, under "Recommendation," are two names and addresses. The first is O. Phillips at 1445 Larimer Street. The second is Natahn Weiner at 2626 W Colfax Ave. The back of the form has a section entitled "Report of the Medical Examiner,"...

Sam Robertz's Application for Admission to JCRS, 1909 May 28

 Item
Identifier: B002.01.0102.0111.00001
Overview Application form of Sam Robertz for admission as a patient to the Jewish Consumptives' Relief Society. He was age 32 at the time of the application. He was born in Russia and emigrated to the United States in 1904. He lived in Brooklyn, New York when he contracted tuberculosis. He had been sick for four years upon arrival to Denver, Colorado. The verso of the application states he was suffering from the second stage of tuberculosis. He was admitted on June 8, 1909 and was discharged on August...

Sam Robertz's Application for Admission to JCRS, 1910 April 6

 Item
Identifier: B002.01.0102.0111.00003
Overview Application form of Sam Robertz for admission as a patient to the Jewish Consumptives' Relief Society. He was age 34 at the time of the application. He was born in Russia and emigrated to the United States in 1904. He lived in Brooklyn, New York when he contracted tuberculosis. He had been sick for five and a half years upon arrival to Denver, Colorado. He was married and had four children. The verso of the application exhibits a red stamp that says "EMERGENCY" and the application states he was...

Sam Schmittmeyer's Application for Admission to JCRS, 1909 December 29

 Item
Identifier: B002.01.0103.0154.00001
Overview Application form of Sam Schmittmeyer for admission as a patient to the Jewish Consumptives' Relief Society. He was age 20 at the time of the application. He was born in Austria and immigrated to the United States in 1893. He lived in New York City when he contracted tuberculosis. He had been sick for two months upon arrival to Denver, Colorado. His occupation states he worked as a law clerk. The verso of the application states he submitted an application on December 29, 1909. The verso also...

Sam Schmittmeyer's Application for Admission to JCRS, 1911 February 9

 Item
Identifier: B002.01.0103.0154.00014
Overview Application form of Sam Schmittmeyer for admission as a patient to the Jewish Consumptives' Relief Society. This application states he was age 19 at the time of the application. He was born in New York. He lived in New York City when he contracted tuberculosis. He had been sick for 18 months. His occupation states he worked as a law clerk. The verso of the application states he submitted an application on February 9, 1911. The verso also notes that he filled out another application on May 15,...

Sam Stone's Application for Admittance to JCRS, 1910 November 28

 Item
Identifier: B002.01.0103.0113.00001
Overview Sam Stone's handwritten application for admittance to JCRS. Includes information such as age (21), place of birth (Russia), and occupation (painter). He was married, had one child, and his nearest relatives were his wife and uncle, in N.Y. On the backside it reads he was admitted on January 3, 1911, and left on June 7, 1911.

Sam Werman's Application for Admittance to JCRS, 1911 August 28

 Item
Identifier: B002.01.0104.0140.00001
Overview Sam Werman's handwritten application for admittance to JCRS. Includes information such as age (17 1/2), place of birth (Russia), and occupation (office clerk). He was single and his nearest relative was his father in New York. On the backside it reads he was admitted on October 27, 1911, and discharged on September 2, 1912.

Sam Winter's Application for Admittance to JCRS, 1908 July 22

 Item
Identifier: B002.01.0100.0028.00001
Overview Application for admittance to JCRS filled out by hand in ink for Sam Winter. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Sam Winter. The back of the form has section entitled "Report of Medical Examiner," which is dated July 22, 1908. Next to "Remarks" reads "Careful examination fails to elicit definitive signs of tuberculosis. [illegible] examination negative for the same roughness bac. p....