APPLICATION FOR A DISCHARGE
TO THE SOLDIERS' ORPHANS' SCHOOLS
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APPLICATION FOR A DISCHARGE.
To J. P. WICKERSHAM, Superintendent:
SIR: I, the
........................................................... of
..........................................................................................
do hereby make application for h....... discharge from the custody, care
and control which you now possess by virtue of the act, entitled "An
act to provide for the continuance of the education and maintenance of the
destitute orphans of the deceased soldiers and sailors, and the destitute
children of permanently disabled soldiers and sailors of the State,"
approved April 9, 1867, in furtherance whereof, I hereto append the
following statement of facts, with signature and affidavit thereto:
Statement.
The above named
................................................................................
was born on the ....... day of ..................................,
18 , and was a resident of
............................................county, State of Pennsylvania,
where application for admission to school was made, and is at this time a
pupil in the
.................................................................................................................................................................................
And I further declare that my reasons for asking for the discharge of said
child
are................................................................................
...........................................................................................................................................................................................................................
And further, that I now have in my possession ample means for h.....
education and maintenance.
...........................................................................................................
.....................................................................................
P.O.
.....................................................................................
County, Pa.
...............................................................................
and subscribed before me,
this ..........day of ...........................................
187 .
.......................................................................
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