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RED CROSS BADGE NUMBER
5
AMERICAN RED CROSS
80,017
NURSING SERVICES
MILITARY SERIAL NUMBER
N-744035
ANNUAL QUESTIONNAIRE - 1945
CHECK IF YOUR LAST NAME HAS CHANGED
H
NAME (Last, first, middle)
TELEPHONE NO.
2037W
Britton Ida Maude
a
IF MARRIED, GIVE MAIDEN NAME
HUSBAND'S NAME
a
PERMANENT ADDRESS (Street, city, zone, county, state)
403 East 4th St. Hastings, Mid-Western Area, Adams CO., Nebraska.
PRESENT ADDRESS (Street, city, zone, county, state)
Same as bove
M
NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES
RELATIONSHIP
John A. Britton Same
address.
Father
a
DATE OF BIRTH (Month, day, year)
Single
Yes
Marryed
Separated
Widowedx
XD1 vorced
April 8. 1910
&
YES
NO
WHAT LANGUAGES DO YOU SPEAK?
English Know a little French, and German
HIGH SCHOOL GRADUATE
X
a
NAME OF COLLEGE OR
DEGREE OR
UNIVERSITY ATTENDED
LOCATION
INCLUSIVE DATES
MAJOR
C
DIPLOMA
State Teachers' College Kearney, Nebr.
1928-1930
Junior Diploma Education
Hastings, Nebr. 1938-1939
B.A.
Nursing
Hastings College
Working on M.A. In
Uni, of Chicago
Chicago, Ill. Summer 1939 Nursing Education
ARE YOU CURRENTLY
YES
NO
REGISTERED IN (State)
ARE YOU CURRENTLY A MEMBER OF THE AMERICAN
YES
NO
REGISTERED?
X
-
Nebraska and in
NURSES' ASSOCIATION?
X
-
Mani 00 Dd PRESENT EMPLOYMENT If not employed, check
POSITION TITLE (H.N., P.D., inst., staff nurse, etc.)
SERVICE (Medicine, surgery, etc.)
Office nurse
General practive.
CITY
STATE
NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED
Dr. C.W. Guildner
Hastings,
Nebraska.
HEALTH
IF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY
Fairly godd
Honorable disch. déag. Epilepsy, grand mal, mild, cause undetermined.
VOLUNTEER SERVICE
The purpose of the following statements is to identify the nurses who can be counted upon to respond to a call
to participate in a Red Cross chapter program. Please check the "Yes" box only if you are wi illing and able to
serve if called on within the next 12 months.
NAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS
Nebraska Adams County Chapter, Hastings, Nebr.
1. Teach home
YES
NO
Attend an instructors' training program, if offered. (Funds are available for
YES
NO
nursing classes
X
training home nursing instructors. See local chapter.) Think unnecessari further training
Attend disaster institutes, if
YES
NO
2. Serve in case
YES
NO
only in home community
X
In other communities
es
offered, in preparation for service
X
of disaster
4. Accept membership on chapter com-
YES
NO
5. Assist with other chapter
YES
NO
3. Teach nurse's
YES
NO
aide classes
X
mittee should services be needed
programs, as needed
X
X
If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that
YES
NO
you will be able to serve at some time in the future?
IF UNABLE TO SERVE, GIVE MAJOR REASONS-
DATE
SIGNATURE
3/1/46
Aug. 18, 1945.
8
YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR PAITHPOLNESS IN
O
KEEPING US INFORMAD OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE MRS. AND RETURN RUTH TUCKER If PROMPTLI. NEWBERG. to K. TRACRETARY
COMMITTEE NAMED BELOW.
ATTENTION
Fill in committee name and address before sending questionnalire MENT
LANCASTER COUNTY
SECRETARY
AMERICAN RED CROS:
NURSE RECRUITMENT
COMMITTEE
312 so. 12thi SI. is NEER
FORM 1045 Rev. July 1945
78504M
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"ocrText": "to\n?\nitter\n+\nRED CROSS BADGE NUMBER\n5\nAMERICAN RED CROSS\n80,017\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nN-744035\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nH\nNAME (Last, first, middle)\nTELEPHONE NO.\n2037W\nBritton Ida Maude\na\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\na\nPERMANENT ADDRESS (Street, city, zone, county, state)\n403 East 4th St. Hastings, Mid-Western Area, Adams CO., Nebraska.\nPRESENT ADDRESS (Street, city, zone, county, state)\nSame as bove\nM\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nJohn A. Britton Same\naddress.\nFather\na\nDATE OF BIRTH (Month, day, year)\nSingle\nYes\nMarryed\nSeparated\nWidowedx\nXD1 vorced\nApril 8. 1910\n&\nYES\nNO\nWHAT LANGUAGES DO YOU SPEAK?\nEnglish Know a little French, and German\nHIGH SCHOOL GRADUATE\nX\na\nNAME OF COLLEGE OR\nDEGREE OR\nUNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nMAJOR\nC\nDIPLOMA\nState Teachers' College Kearney, Nebr.\n1928-1930\nJunior Diploma Education\nHastings, Nebr. 1938-1939\nB.A.\nNursing\nHastings College\nWorking on M.A. In\nUni, of Chicago\nChicago, Ill. Summer 1939 Nursing Education\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nX\n-\nNebraska and in\nNURSES' ASSOCIATION?\nX\n-\nMani 00 Dd PRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.)\nSERVICE (Medicine, surgery, etc.)\nOffice nurse\nGeneral practive.\nCITY\nSTATE\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nDr. C.W. Guildner\nHastings,\nNebraska.\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\nFairly godd\nHonorable disch. déag. Epilepsy, grand mal, mild, cause undetermined.\nVOLUNTEER SERVICE\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to a call\nto participate in a Red Cross chapter program. Please check the \"Yes\" box only if you are wi illing and able to\nserve if called on within the next 12 months.\nNAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\nNebraska Adams County Chapter, Hastings, Nebr.\n1. Teach home\nYES\nNO\nAttend an instructors' training program, if offered. (Funds are available for\nYES\nNO\nnursing classes\nX\ntraining home nursing instructors. See local chapter.) Think unnecessari further training\nAttend disaster institutes, if\nYES\nNO\n2. Serve in case\nYES\nNO\nonly in home community\nX\nIn other communities\nes\noffered, in preparation for service\nX\nof disaster\n4. Accept membership on chapter com-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\n3. Teach nurse's\nYES\nNO\naide classes\nX\nmittee should services be needed\nprograms, as needed\nX\nX\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that\nYES\nNO\nyou will be able to serve at some time in the future?\nIF UNABLE TO SERVE, GIVE MAJOR REASONS-\nDATE\nSIGNATURE\n3/1/46\nAug. 18, 1945.\n8\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR PAITHPOLNESS IN\nO\nKEEPING US INFORMAD OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE MRS. AND RETURN RUTH TUCKER If PROMPTLI. NEWBERG. to K. TRACRETARY\nCOMMITTEE NAMED BELOW.\nATTENTION\nFill in committee name and address before sending questionnalire MENT\nLANCASTER COUNTY\nSECRETARY\nAMERICAN RED CROS:\nNURSE RECRUITMENT\nCOMMITTEE\n312 so. 12thi SI. is NEER\nFORM 1045 Rev. July 1945\n78504M"
}