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FORM 1045 REV. JAN 1941 AMERICAN RED CROSS NATIONAL HEADQUARTERS WASHINGTON, D. C. Name in full JUREWICZ Helen Veronica (MIDDLE) Year of Birth 1912 (SURNAME) (FIRST) Husband's name Permanent address 218Augusta South Anday (CITY) III.ddlesex (COUNTY) (STATE) New Jersey (STREET Probable address for the next year American (STREET) Rad Cross (CITY) Headquarters, (COUNTY) London (STATE) England Telephone number Plaza (EXCHANGE) 5 3970 (NO.) (present tel. no.) Give name and address of nearest relative or friend in United States: TIIrs. George Kelly Aunt 218 Auqusta 5v. Sour Ambey (RELÄTIONSHIP) (ADDRESS) (NAME) PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Mitropolitan Hospital, Welfare Ts. Public Health Private duty Other (write in) Government Service: Army U.S.P.H. Service Veterans Administration Navy U.S.Indian Service Children's Bureau MAJOR ESPONSIBILITIES Adminis Super Teach General Private Other of present employment tration vision ing Staff Duty (specify) IF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar: Institutional Public Health Private duty Other (WRITE IN) AVAILABILITY I have an appointment to *h, American Red Cross - Horugr'/ Hospital in Englond At the present time would you Date Mor 15, accept assignment to the Army? Yes No Navy? Yes No available In case of a war emergency would you accept assignment to the Army? Yes No Navy? Yes No If not now employed would you accept nursing work? Full-time? Yes No Part-time? Yes No In your own community? Yes No Elsewhere? Yes No Would you be interested in teaching classes in Home Hygiene and Care of the Sick? No 8 Present physical condition good a Badge No. 81275 Current date 2/3/41 J W Name of Committee MANHATT AN of Note: If a nurse does not complete and return this questionnaire, and cannot be located within two years, her enrollment will be removed from our active files.

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81
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    "ocrText": "FORM 1045\nREV. JAN 1941\nAMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nName in full JUREWICZ Helen Veronica (MIDDLE) Year of Birth 1912\n(SURNAME)\n(FIRST)\nHusband's name\nPermanent\naddress 218Augusta South Anday (CITY) III.ddlesex (COUNTY) (STATE) New Jersey\n(STREET\nProbable address\nfor the next year\nAmerican (STREET) Rad Cross (CITY) Headquarters, (COUNTY) London (STATE) England\nTelephone\nnumber Plaza (EXCHANGE) 5 3970 (NO.) (present tel. no.)\nGive name and address of nearest relative or friend in United States:\nTIIrs. George Kelly\nAunt\n218 Auqusta 5v. Sour Ambey\n(RELÄTIONSHIP)\n(ADDRESS)\n(NAME)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nMitropolitan Hospital, Welfare Ts.\nPublic Health\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S.Indian Service\nChildren's Bureau\nMAJOR ESPONSIBILITIES Adminis\nSuper\nTeach\nGeneral\nPrivate\nOther\nof present employment\ntration\nvision\ning\nStaff\nDuty\n(specify)\nIF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther\n(WRITE IN)\nAVAILABILITY\nI have an appointment to *h, American\nRed Cross - Horugr'/ Hospital in Englond\nAt the present time would you\nDate Mor 15,\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable\nIn case of a war emergency would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\nIf not now employed would you\naccept nursing work? Full-time? Yes\nNo\nPart-time? Yes\nNo\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nNo\n8\nPresent physical condition good\na\nBadge No. 81275\nCurrent date 2/3/41\nJ\nW\nName of Committee\nMANHATT AN\nof\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enrollment will be removed from our active files."
}