Rules for Admission

A physical examination is required.

Before admission to the Home execution of the following agreements is
expected:

New Haven, ........................ 192 .....
I hereby agree that if ...............................................
who has been accepted and admitted upon my request as an inmate of the
Home for the Friendless, shall be found, after reasonable trial, to be
unsuitable to remain as such inmate, I will, as soon as possible after being
notified to that effect, remove the said .....................
from the care and custody of said Home.

I also agree to pay $........ per week-Month for the care and board
of said ........................ as long as she remains
an inmate of said Home; and I also agree to pay for proper medical
attendance, and service and boatd of a nurse for said .......................
in case she should ned such medical attendance and service beyond that
which can be coneniently provided by said Home.

Witness:

.................................. (L.S.) .............................

New Haven, ........................ 192 ..... In consideration of the agreement of the Home for the Friendless to
permit me to become an inmate in said Home—so long as said Home deems
me to be suitable inmate—at the reduced rate of $..........per week—
month—for care and board, I hereby agree that:

The amount representing the difference between what shall be paid per
week—month—as above set forth, for my care and board while I am an
inmate thereof, and the actual cost to said Home of such care and board,
if not paid by me during my life, and if not provided for by me by will in
favor of said Home, shall be a legal claim upon any estate of which I may
die possessed, regardless of any disposition of my estate to others made by
me by will, and such claim shall be paid to said Home by my executor or
administrator upon due proof of this agreement and of the facts and figures
upon which such claim is based; it being my intention hereby to show my
appreciation for the care and service which said Home has agreed to
provide for me, and to reinburse said Home for such care and service to
the extent of my ability.

.................................. (L.S.) .............................