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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:

B. Lieberman's Application for Admittance to JCRS, 1908 October 13

 Item
Identifier: B002.01.0100.0081.00001
Overview JCRS application for admittance filled out in ink for Patient #937 B. Lieberman "[t]o the Executive Committee of the Jewish Consumptives' Relief Society, Denver, Colorado...Received October 13th 1908." The application includes patient's name, gender, age, citizenship, occupation, residential and medical history, and the application is signed Bessie Lieberman. The bottom third of the application reads "RECOMMENDATION" and has been left blank. The back of the application reads "REPORT OF MEDICAL...
Dates: 1908 October 13

Bailie Siegel's Application for Admittance to JCRS, 1911 October 11

 Item
Identifier: B002.01.0104.0167.00001
Overview Bailie Siegel's handwritten application for admittance to JCRS. Includes information such as age (33), place of birth (Russia), and occupation (housewife). She was married, had 2 children, and her nearest relative was her husband, in Chicago, Ill. On the back side it reads she was admitted on November 16, 1911, and left on February 01, 1912.
Dates: 1911 October 11

Banjamin Wigatow's Application for Admission to JCRS, 1911 September 18

 Item
Identifier: B002.01.0104.0158.00001
Overview Application form of Banjamin Wigatow for admission as a patient to the Jewish Consumptives' Relief Society. He was age 21 at the time of the application. He was born in Russia and immigrated to the United States in 1906. He lived in New York City when he contracted tuberculosis. He had been sick for five months upon his arrival to Denver, Colorado. His occupation states he worked as a cigar maker. The verso of the application does not state any admission or discharge dates.
Dates: 1911 September 18

Barnet Cohen's Application for Admittance to JCRS, 1911 March 31

 Item
Identifier: B002.01.0104.0021.00001
Overview Barnet Cohen's handwritten application for admittance to JCRS. Includes information such as age (41), place of birth (Russia), and occupation (merchant). He was married, had 6 children, and his nearest relatives were his wife and brothers in Kansas City. On the backside it reads he was admitted on May 3, 1911, and left on July 26, 1911.
Dates: 1911 March 31

Barnet Ginsburg's Application for Admittance to JCRS, 1908 December 22

 Item
Identifier: B002.01.0101.0001.00023
Overview Application for admission to JCRS filled out by hand in ink for B. Ginsburg. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by B. Ginsburg. Lists nearest relatives as "Flower City Lodge #281 I.O.B.A. in Rochester, NY (Louis Rosenzweig, secy), (friend) Gordon Bros., Front St Rochester NY, (cousin) Chas Michlin 81 Kelly St Rochester NY." At the bottom of the page, the section "Recommendation," is left...
Dates: 1908 December 22

Barnet Jacobs' Application for Admittance to JCRS, 1908 July 17

 Item
Identifier: B002.01.0100.0026.00001
Overview Application for admittance to JCRS filled out by hand in ink for Barnet Jacobs. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, nearest relatives, and signed by Barnet Jacobs. The back of the form has section entitled "Report of Medical Examiner," next to stage reads "Condensation, No moisture." Next to "Remarks" reads "Patient has arrested functioning of Right apex-No fever-[Threat unstable]" and is signed Emanuel Friedman. The...
Dates: 1908 July 17

Barney Eisenberg's Application for Admittance to JCRS, 1910 January 15

 Item
Identifier: B002.01.0102.0062.00001
Overview Handwritten application in ink for admittance to the JCRS for "Barnie Isenberg". It includes information such as age (34), and place of birth (Russia). He was married and had one child, and had been in the National Jewish Hospital. On the backside it is written he was admitted as an emergency case on January 15, 1910, and he was discharged on September 14, 1910.
Dates: 1910 January 15

Bell Yudelson's Application for Admittance to JCRS, 1909 May 19

 Item
Identifier: B002.01.0101.0065.00001
Overview Application for admittance to JCRS filled out by hand in ink for Bell Yudelson. Information on the form includes her age, place of birth, occupation, residence, marital status, nearest relatives, and signed by Bell Yudelson. 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 examination was conducted May 19, 1909 and the results were that the patient suffers from...
Dates: 1909 May 19

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,...
Dates: 1909 February 15

Ben Lorenz's Application for Admission to JCRS, 1910 February 28

 Item
Identifier: B002.01.0102.0085.00001
Overview Ben Lorenz's application for admittance into the Jewish Consumptives' Relief Society in Denver, Colorado. He was age 26 when admitted on February 28, 1910. The application also mentions that he was born in New York, but came from Chicago, Illinois where his mother and brother still resided. His occupation was as a clothing cutter. He was also admitted to the Modern Woodmen Sanatorium in Colorado Springs prior to arriving at JCRS in Denver. The verso is a "Report of Medical Examiner" and lists...
Dates: 1910 February 28