D.—No. 5,
£ s. d, J. Wright, Esq 10 0 J. V. M 0 5 0 Q- R. S 15 o o Offertory at Christ Church, Cannes 12 11 0 I\ Peak, Esq.—Third donation ... 12 10 0 Rev. H.G.J. C 10 0 0 The Lord Henry Percy ... ... 500 Dr. Bisset Hawkins—2nd donation 5 0 0 Ascot Hope, Esq 5 0 0 X. T. Z 17 5 0 B. Shaw, Esq 20 0 0 C. H. Bousfield, Esq 10 0 Lieut.-General M. Stuart ... ... 5 5 0 Loftus T. Wigram, Esq. ... 25 0 0 T. H 2 0 0 Eev. Dr. Huntingfield ~. ... 10 0 0 A. A. Vansittart, Esq. 10 0 0 Basil J. Haines, Esq.... ... ... 2 10 Henry Buxton, Esq. ... ... 10 0 0 H. Bonham Carter, Esq. ... ... 10 0 0 Mrs. Bonham Carter... ... ... 10 0 0 Edmund Currie, Esq. ... ... 20 0 0 W. D. Eouth, Esq 5 0 0 F. H 0 10 0 E. W 20 0 0 E. R. Torrens, Esq., M.P 3 0 0 A. B. Abraham, Esq. ... ... 2 2 0 C. H. W. a Court Eepington, Esq.... 10 0 0 H. W. Prescott, Esq. —3rd donation 10 0 0 W. B. Gurdon, Esq 2 0 0 Edward Smyth, Esq 10 0 I-M 10 io 0
£ s. d. Miss Florence Nightingale 10 0 0 W. H. Eichardson, Esq 25 0 0 George C. Courthope, Esq. ... 10 0 0 E. E 5 0 0 G. J. Buck, Esq... *... 20 0 0 J. Drake, .Esq... ... .., 100 H. Currie, Esq. ... ... ... 25 0 0 Admiral Sir T. Hastings .., ... 3 0 0 Lady A. B. W. Horton 50 0 0 Miss Donaldson ... ... ... 1 10 0 "Brown" 20 0 0 C. W. Digby, Esq 10 0 0 P-O. 0 2 0 0 A. H. Probert, Esq. ... ... ... 5 00 E. Blombert, Esq. 3 0 0 -J. W. Read, Esq. " 50 0 J. W. Overbury, Esq. ... ... 10 0 0 A. J. Kennard, Esq. ... ... ... 15 o 0 Rev. J. Hildyard ... ... ... 100 Alfred Braby, Esq 100 Mrs. Valpy ... 2 2 0 h. c.c :; ;:: 50 o Thomas Barnard, Esq 5 0 0 Lieut.-General the Hon. Sir Edward Cust, G.C.B. ... ... ... 10 0 0 Miss Catherine Stanley 10 0 0 Lady Clarges 20 0 0 Edward Lake, Esq. ... ... ... 5 00 Richard Hunter, Esq 20 0 0 J. J. Briscoe, Esq., M.P 50 0 0 General Sir George Bowles ... ... 50 0 0
Enclosure 2 in No. 1. The Beitish and Colonial Emigkation Fund. Application Paper. No. Name Age Address 1. Can you read and write ? If so, write your name opposite. 2. How long have you been resident in London ? 3. How long resident in the parish in which you now reside ? 4. Have you ever received parochial relief? 5. Are you married or single ? 6. If married, state the name and age of your wife, and the names and ages of your children 7. Is any increase in your family expected within the next four months ; if so, when ?* 8. What is your trade or employment ? 9. How long out of employment ? 10. Name and address of your last employer ? 11. Have you any means to assist yourself in emigrating, or can your friends assist you ? 12. Can you provide the necessary outfit for the voyage ? Ido hereby declare, that all the above statements are true; and, in consideration of the kindness of the Committee m assisting me to emigrate, I undertake to repay the sum advanced for my passage &c, as soon as my improved circumstances in the Colony may enable me to do so.f Date Signature
Certificate to be Signed by last Employer or by two Respectable Householders. _ I [or we] certify that I [or we] have perused the foregoing statements, and believe them to be strictly true. That lam [or we are] well acquainted with and believe him to be honest, sober, and industrious, and of general good character. Name Address Name Address
Certificate of a Physician or Surgeon. I certify that I have examined the above-named applicant and his wife and children, and that they are none of them mutilated or deformed in person, or of unsound mind. They have been vaccinated, or had the small-pox, or are free from disease considered infectious or contagious. Name Residence
fi* d' B 'T Th d ? UeSti ° U " asked that th ° Committe e may be aware if there is any probability of your -wife being t N.B.—Such repayments will, in all cases, be applied to the emigration of other unemployed workmen.
5
BRITISH AND COLONIAL EMIGRATION EUND.