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{
    "localId": "2661263",
    "label": "Colvin, Mrs. Amy M. (Henry) nee Amy M. Hilliard",
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    "id": "2661263",
    "sourceUrl": "https://catalog.archives.gov/id/2661263",
    "contentType": "document",
    "title": "Colvin, Mrs. Amy M. (Henry) nee Amy M. Hilliard",
    "citationUrl": "https://catalog.archives.gov/id/2661263",
    "collections": [
        "Records of the American National Red Cross",
        "Historical Nurse Files"
    ],
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    "url": "https://catalog.archives.gov/id/2661263",
    "naId": 2661263,
    "coverageEndDate": {
        "day": 15,
        "logicalDate": "1959-05-15",
        "month": 5,
        "year": 1959
    },
    "coverageStartDate": {
        "day": 18,
        "logicalDate": "1909-03-18",
        "month": 3,
        "year": 1909
    },
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{
    "seq": 10,
    "pageIndex": 0,
    "type": "photo",
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    "ocrText": "I\nL\n619\nRED CROSS BADGE NUMBER\nis\nAMERICAN RED CROSS\nD\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nAmy\n3\nTS\nNAME (Last, first, middle)\nTELEEPHONE NO.\nCOLVIN - AMY-\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nProy 2696\nAMY MAY HILLIARD\nHENRY COLVIN\nM\nD\nPERMANENT ADDRESS (Street, city, zone, county, state)\n42 SECOND ST.\nin\nPRESENT ADDRESS (Street, city, zone, county, state)\nTROV - RENSS. CO. N.Y\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nMOTHER 51 KENMOREAVE. INEWARK. N.J.\nMRS HENRY HILLIAM 1)\nDATE OF BIRTH (Month, day, year)\nlingle\nMarried\nSeparáted\nWidowed\nDivorced\nM.\nWHAT LANGUAGES DO YOU SPEAK?\nYES\nNO\nENGLISH\nHIGH SCHOOL GRADUATE\nNAME OF COLLEGE OR\nDEGREE OR\nUNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nN.Y.\nNURSES' ASSOCIATION?\nYES\nPRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., instr, staff nurse, etc.)\nSERVICE (Medicine, surgery-etc.)\nNAME OF HOSPITAL OR- ORGANIZATION BY WHOM EMPLOYED\nCITY\nSTATE\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\nRECENT PHYSICAL E XAM.\nNEGATIVE\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 willing 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\nPens. Co\n1. Teach home\nYES\nNO\nAttend an instructors' training program, 1f offered. (Funds are available for\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\n2. Serve in case\nYES\nNO\nonly in home community\nAttend disaster institutes, if\nYES\nNO\nof disaster\nIn other communities\noffered, in preparation for service\n3. Teach nurse's\nYES\nNO\n4. Accept membership on chapter cóm-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\naide classes\nmittee should services be needed\nprograms, as needed\nIf you have not answered aves* 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?\nNO-\nIF UNABLE TO SERVE, GIVE MAJOR REASONS\nDATE\nS IGNATURE\naugust 24/1945\nany Coloein\nYOUR VALUE AS 4 RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND. YOUR PAITHPOLNESS IN\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE PILL IN THIS QUESTIONNAIRE AND RETURN If PROMPTLY TO THE\nCOMMITTEE NAMED BBLOV.\na\nATTENTION\nFill in committee name and address before sending questionnaire to nurse.\nSECRETARY\nNURSE RECRUITMENT\nRensselaer County Recruitment Committee,\nCOMMITTEE\nProctor Building, Troy, N. Y.\n78504M\nFORM 1045 Rev. July 1945"
}