APPLICATION FOR ADMISSION TO SALEM INDIAN
INDUSTRIAL SCHOOL, CHEMAWA, OREGON.
(Applicants will please answer the following questions in their own hand
writing:)
: "9
Write your full name here
Post Office address .
Railroad Point , T
What is your tribe?
How much Indian blood do you possess?
Have you good health?
Have you perfect eyesight?
Have you any bodily defect, natural, or as result of disease or accident?
What is your age on your text birthday? '.
What is your height? and your weight?
What school or schools have you attended, and for how long? .
What work have you done? .
What trade or line of industrial work do you wish to learn?
I
If admitted do you promise to abide by the rules and regulations of the
school? : .
Sign your name here. .
. (Applicants,) who do not live on Indian reservations, must have their
nearest -Post-Master- endorse-their-application and certify to correctness of
statements made.) . .
Endorsement of Post Master at
Remarks:
Post Master.
The undersigned parent or guardian of
hereinj consents freely and witlwut compxdsion to the transfer of
" from selisol
to the scJwol at