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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 599 Collections and/or Records:

Bennie Weinstein's Application for Admittance to JCRS, 1908 November 30

 Item
Identifier: B002.01.0100.0106.00001
Overview Application for admittance to the JCRS Sanatorium filled out by hand in ink for Bennie Weinstein. Information on the front of the form includes his age, birth place, citizenship, occupation, recent resident information, medical information, marital status, and nearest relatives or friends "Rachel Weinstein (sister) Elizabeth PA Oscar Weinstein (brother)" [sic]. The form is signed Bennie Weinstein Address 1471 Knox Court [Denver, CO], followed by section headed RECOMMENDATION, which was left...

Bernhard Adler's Application for Admission to JCRS, 1911 February 24

 Item
Identifier: B002.01.0103.0160.00001
Overview Application form of Bernhard Adler for admission as a patient to the Jewish Consumptives' Relief Society. He was age 40 at the time of the application. He was born in Russia and immigrated to the United States in 1904. He lived in Milwaukee when he contracted tuberculosis. He had been sick for 1 year upon arrival to Denver, Colorado. He was married and had four children. He also worked as a tailor. He belonged to the United Israelite Society of Wisconsin. The verso of the application states he...

Bertha Hoffman's Application for Admittance to JCRS, 1909 December 13

 Item
Identifier: B002.01.0102.0057.00001
Overview Handwritten application in ink for admittance to the JCRS for Bertha Hoffman. It includes information such as age (17), place of birth (Russia), and occupation (school girl). She has been to the National Jewish Hospital, and her means of support is her parents. Her nearest relative is her sister, A. Wofson, in Denver. On the backside, it is written she was admitted as an emergency case on December 14, 1909, and she died on December 16, 1909.

Bertha Jacobs' Application for Admittance to JCRS, 1909 November 22

 Item
Identifier: B002.01.0102.0028.00001
Overview Application for admission to JCRS filled out by hand in ink for (mrs) Bertha Jacobs. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, and nearest relatives. Form is signed "Bertha Jacobs 1460 Lowell Blvd." Nearest relative is listed as "Husband David Jacobs, Boyers, Pa." The Recommendation section at the bottom of the page is blank. The section "Report of the Medical Examiner" on the back side of the reports that Mrs Jacobs is...

Bessie Fechter's Application for Admittance to JCRS, 1910 January 11

 Item
Identifier: B002.01.0102.0061.00001
Overview Handwritten application in ink for admittance to the JCRS for Bessie Fechter. It includes information such as age (32), place of birth (Austria), and occupation (housewife). She was married and had 2 children, and she has been in the National Jewish Hospital for one year. Her nearest relative is her husband, Max Fechter, in Cleveland, and her father, Benj. Marmon, in New York. On the backside, it is written she had tuberculosis stage II, involvement on right upper lobe. She was admitted on...

Blank Application, undated

 Item
Identifier: B002.01.0104.0125.00003
Overview Blank application. The front page is blank, and on the backside it reads "original attached hereto."

Blank Application Form, 1911 August 8

 Item
Identifier: B002.01.0104.0131.00002
Overview Blank application for admittance to JCRS. The front part is blank, and the backside reads Anna Rosenberg was amitted to the sanatorium on October 26, 1911, and left on December 22, 1911.

Carrie Kokush's Application for Admittance to JCRS, 1909 November 5

 Item
Identifier: B002.01.0102.0021.00001
Overview Application for admission to JCRS filled out by hand in ink for Carrie Kokush. Information on the form includes his age, birth place, occupation, residence, marital status, children's ages, and nearest relatives. Form is signed "Carrie H Kokush." Nearest relative is listed as "a Hruschka, 319 Washingtton st. Father." In the Recommendation section at the bottom of the page is left blank. The section "Report of the Medical Examiner" on the back side of the form states examination took place on...

Catherine Queen's Application for Admission to JCRS, 1911 February 21

 Item
Identifier: B002.01.0103.0161.00001
Overview Application form of Catherine Queen for admission as a patient to the Jewish Consumptives' Relief Society. She was age 40 at the time of the application. She was born in Russia and immigrated to the United States in 1894. She lived in Philadelphia when she contracted tuberculosis. She had been sick for 10 years upon arrival to Denver, Colorado. She was a widow at the time of filling out the application. She was admitted to the National Jewish Hospital before applying for JCRS. The verso of the...

Catherine Queen's Application for Admittance to JCRS, 1909 May 10

 Item
Identifier: B002.01.0101.0059.00002
Overview Application for admittance to JCRS filled out by hand in ink for Catherine Queen. Information on the form includes her age, place of birth, occupation, residence, marital status, previous hospital stays, nearest relatives, and signed by Catherine Queen. At the bottom of the page, under "Recommendation," are two names and addresses. The first reads "Barney [illegible], 1459 Knox Ct," and the second reads "Leon Mussoff, N 1569 Julian St." The back of the form has section entitled "Report of...