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FORM 1045 REV. 2-16-31 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN ROBERT w. DE FOREST, VICE PRESIDENT MRS. AUGUST BELMONT CALVIN COOLIDGE, VICE PRESIDENT THE AMERICAN RED CROSS CORNELIUS N. BLISS MABEL T. BOARDMAN CHARLES EVANS HUGHES, VICE PRESIDENT JOSEPH P COTTON TROMAS D. THACHER, COUNSELOR NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON OGDEN L. MILLS, TREASURER MRS. FRANK v. HAMMAR MABEL T. BOARDMAN, SECRETARY WASHINGTON, D.C. MAJ. GEN. M. w. IRELAND SAMUEL KNIGHT OGDEN L. MILLS NATIONAL EXECUTIVE OFFICERS GUSTAVUS D. POPE MRS, HENRY . REA JOHN BARTON PAYNE, CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS JAMES L. FIESER, VICE CHAIRMAN JOHN D. RYAN GEORGE E. SCOTT ERNEST P. BICKNELL, VICE CHAIRMAN HENRY UPSON SIMS JAMES K. Mcclintock, VICE CHAIRMAN THOMAS D. THACHER ELIOT WADSWORTH B Dear Madam: The National Committee on Red Cross Nursing Service requires us to submit, annually, a list of all the Red Cross Nurses enrolled with our Committee, with their latest addresses. We are extremely anxious to make a very complete report to National Headquarters and ask for your cooperation. Please answer the following questions and return this form to me, in enclosed envelope, at the earliest possible date. IMPORTANT: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross Carolyn Schmoker Chairman Secretary. or Nurses should report at once to the Secretary of the Local Committee under which they are enrolled. Do not forget Local Committee. the address of the Secretary. Name in full miss alice B.P Conover If married, give husband's name Permanent address 7 Hillside are Summist Union STREET, ETC. CITY COUNTY Ang 1 STATE Probable address for the next year Some STREET, ETC. Telephone No. 6-0055-W. CITY COUNTY STATE Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Underline Reo 7.Ch. Conover Bernardeville h go the type of work you are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian Registrar. Retired Service - Public Hoalth - Institutional - Private Duty - Industrial - Office Nurse - Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no Have you ever been? no Indicate present physical condition not LO good (age 67 in may) Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Badge No. 12319 Current date Fet 5.th 1932 3 NOTE. -- If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrolment will be annulled.

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    "ocrText": "FORM 1045 REV. 2-16-31\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST, VICE PRESIDENT\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nCHARLES EVANS HUGHES, VICE PRESIDENT\nJOSEPH P COTTON\nTROMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nOGDEN L. MILLS\nNATIONAL EXECUTIVE OFFICERS\nGUSTAVUS D. POPE\nMRS, HENRY . REA\nJOHN BARTON PAYNE, CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJAMES L. FIESER, VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nERNEST P. BICKNELL, VICE CHAIRMAN\nHENRY UPSON SIMS\nJAMES K. Mcclintock, VICE CHAIRMAN\nTHOMAS D. THACHER\nELIOT WADSWORTH\nB\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nCarolyn Schmoker Chairman Secretary.\nor\nNurses should report at once to the\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nLocal\nCommittee.\nthe address of the Secretary.\nName\nin full miss alice B.P Conover\nIf married, give husband's name\nPermanent address 7 Hillside are Summist Union\nSTREET, ETC.\nCITY\nCOUNTY\nAng 1 STATE\nProbable address for the next year Some\nSTREET, ETC.\nTelephone No. 6-0055-W.\nCITY\nCOUNTY\nSTATE\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline Reo 7.Ch. Conover Bernardeville h go\nthe type of work\nyou are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian\nRegistrar. Retired\nService - Public Hoalth - Institutional - Private Duty - Industrial - Office Nurse -\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been?\nno\nIndicate present physical condition not LO good (age 67 in may)\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 12319\nCurrent date Fet 5.th 1932\n3\nNOTE. -- If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}