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N I 6. a L e 5 FORM 1045--REV. 2-24-27 NATIONAL OFFICERS CENTRAL COMMITTEE L P JOHN BARTON PAYNE, CHAIRMAN CALVIN COOLIDGE. PRESIDENT MRS, AUGUST BELMONT 0 ROBERT w. DE FOREST, VICE PRESIDENT CORNELIUS N. BLISS WILLIAM HOWARD TAFT. VICE PRESIDENT THE AMERICAN RED CROSS MABEL T. BOARDMAN L 9 MRS, HENRY P. DAVISON WILLIAM D. MITCHELL, COUNSELOR NATIONAL HEADQUARTERS CHARLES s. DEWEY CHARLES s. DEWEY, TREASURER E.B. DOUGLAS + MABEL T. BOARDMAN. SECRETARY WASHINGTON. D. c. JOSEPH c. GREW MRS. FRANK v. HAMMAR HERBERT HOOVER MAJ. GEN. M. w. IRELAND NATIONAL EXECUTIVE OFFICERS WILLIAM D. MITCHELL w.w. MORROW JOHN BARTON PAYNE, CHAIRMAN GUSTAVUS D, POPE JAMES L. FIESER, VICE CHAIRMAN MRS. HENRY R. REA ERNEST P. BICKNELL. VICE CHAIRMAN JOHN D. RYAN GEORGE E. SCOTT REAR ADMIRAL E. R, STITT H Mrs S L P Dear Madam: < The National Committee on Red Cross Nursing Service requires us to submit B (b annually, a list of all the Red Cross Nurses enrolled with our Committee, with their 5 latest addresses. We are extremely anxious to make a very complete report to National (b Headquarters and ask for your cooperation. Please answer the following questions and c a return this form to me, in the enclosed envelope, at the earliest possible date. K IMPORTANT: In order to render prompt service Yours sincerely, Chairman 9r in time of disaster, enrolled Red Cross nurses should report at once to the Secretary. Secretary of the Local Committee under which they are enrolled. Do not forget Local Committee. the address of the Secretary Name in full Louenia rene Beek If married, give husband's name Permanent address morning Sun, lowa Probable address for the next year Indifinite Telephone No. 1880 Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Mrs Henry Buk morning Sun, lown Underline the type of work you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar. Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no. Have you ever been? yes Indicate present physical condition excellent Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? year Badge No. 37892 Current date may 30, 1928 NOTE. - If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrollment will be annulled.

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    "ocrText": "N\nI\n6.\na\nL\ne\n5\nFORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nL\nP\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. PRESIDENT\nMRS, AUGUST BELMONT\n0\nROBERT w. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nL\n9\nMRS, HENRY P. DAVISON\nWILLIAM D. MITCHELL, COUNSELOR\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nCHARLES s. DEWEY, TREASURER\nE.B. DOUGLAS\n+\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D. c.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nMAJ. GEN. M. w. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nWILLIAM D. MITCHELL\nw.w. MORROW\nJOHN BARTON PAYNE, CHAIRMAN\nGUSTAVUS D, POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nREAR ADMIRAL E. R, STITT\nH\nMrs\nS\nL\nP\nDear Madam:\n<\nThe National Committee on Red Cross Nursing Service requires us to submit\nB\n(b\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\n5\nlatest addresses. We are extremely anxious to make a very complete report to National\n(b\nHeadquarters and ask for your cooperation. Please answer the following questions and\nc\na\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nK\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nChairman 9r\nin time of disaster, enrolled Red Cross\nnurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nLocal\nCommittee.\nthe address of the Secretary\nName in full\nLouenia rene Beek\nIf married, give husband's name\nPermanent address\nmorning Sun, lowa\nProbable address for the next year\nIndifinite\nTelephone No. 1880\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nMrs Henry Buk morning Sun, lown\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no.\nHave you ever been? yes\nIndicate present physical condition excellent\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? year\nBadge No. 37892\nCurrent date may 30, 1928\nNOTE. - If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
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