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FORM No. 469-(3)
THE AMERICAN RED CROSS
aTo
a
17
ENROLLMENT FORM
a
S
M
W
Voyage number
D
From,
To
DIVISION OF FILES AND RECORDS,
Nursing Department
BUREAU OF PERSONNEL.
Date
2
4-15-18
Approved Clara Dongly
ella
1. Name
Backus; Marian As 19024
2. Address
218-West-36th st. Minnenpolis; Minn
3. Temporary address, if any
4. Going to what countries
Franco
5. Nature of work
Infant Welfaro, (Swan Schadule,N=2) 6. Suggested rank
7. Length of stay (six months or over?)
1 year or more
8. Proposed approximate date of departure May Ist. 191-Booked May 7 Sailed
9. Cable number in compliance with which above is being sent
1703
10. Is appointee volunteer?
Chargeable to
No
Appropriation No.
11. If not volunteer, what salary per month is promised? $.60.00
12. To beginril 21st
13. What allowance, if any, for transportation in United States? $. Yes, both Ways
14. What allowance, if any, for transportation (steamship)? both-ways
15. What allowance, if any, for living expenses prior to departure? $3.00 a day for time in New York
16. What allowance, if any, for uniform equipment? $ Yes, regulation quipment
17. What allowance, if any, for living expenses abroad? SYes, regulat allowance
18. Is there to be an assignment of part or all of salary?
19. Has the proper form been sent to the Life Extension Institute?
THE AMERICAN RED CROSS
PASSPORT BUREAU,
NATIONAL HEADQUARTERS
WASHINGTON, D. c.
DEPARTMENT OF STATE,
1423 New YORK AVENUE,
WASHINGTON, D. C.
of
appointed
in the service of the American National Red Cross, expects to sail
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"ocrText": "M\nFORM No. 469-(3)\nTHE AMERICAN RED CROSS\naTo\na\n17\nENROLLMENT FORM\na\nS\nM\nW\nVoyage number\nD\nFrom,\nTo\nDIVISION OF FILES AND RECORDS,\nNursing Department\nBUREAU OF PERSONNEL.\nDate\n2\n4-15-18\nApproved Clara Dongly\nella\n1. Name\nBackus; Marian As 19024\n2. Address\n218-West-36th st. Minnenpolis; Minn\n3. Temporary address, if any\n4. Going to what countries\nFranco\n5. Nature of work\nInfant Welfaro, (Swan Schadule,N=2) 6. Suggested rank\n7. Length of stay (six months or over?)\n1 year or more\n8. Proposed approximate date of departure May Ist. 191-Booked May 7 Sailed\n9. Cable number in compliance with which above is being sent\n1703\n10. Is appointee volunteer?\nChargeable to\nNo\nAppropriation No.\n11. If not volunteer, what salary per month is promised? $.60.00\n12. To beginril 21st\n13. What allowance, if any, for transportation in United States? $. Yes, both Ways\n14. What allowance, if any, for transportation (steamship)? both-ways\n15. What allowance, if any, for living expenses prior to departure? $3.00 a day for time in New York\n16. What allowance, if any, for uniform equipment? $ Yes, regulation quipment\n17. What allowance, if any, for living expenses abroad? SYes, regulat allowance\n18. Is there to be an assignment of part or all of salary?\n19. Has the proper form been sent to the Life Extension Institute?\nTHE AMERICAN RED CROSS\nPASSPORT BUREAU,\nNATIONAL HEADQUARTERS\nWASHINGTON, D. c.\nDEPARTMENT OF STATE,\n1423 New YORK AVENUE,\nWASHINGTON, D. C.\nof\nappointed\nin the service of the American National Red Cross, expects to sail"
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