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FORM 1045--REV. 2-24-27
in
e.
NATIONAL OFFICERS
CENTRAL COMMITTEE
L
JOHN BARTON PAYNE, CHAIRMAN
CALVIN COOLIDGE. PRESIDENT
P.
MRS, AUGUST BELMONT
ROBERT w. DE FOREST, VICE PRESIDENT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
MRS, HENRY P. DAVISON
aN
WILLIAM D. MITCHELL, COUNSELOR
9
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
NATIONAL EXECUTIVE OFFICERS
MAJ. GEN. M. w. IRELAND
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
Mr.
H
7
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L
Dear Madam:
P
The National Committee on Red Cross Nursing Service requires us to submit,
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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
B
(b
5
Headquarters and ask for your cooperation. Please answer the following questions and
e
return this form to me, in the enclosed envelope, at the earliest possible date.
C
a
IMPORTANT:
!
Yours sincerely,
In order to render prompt service
in time of disaster, enrolled Red Cross
Hanniette gonkeys
Chairman or
Secretary
nurses should report at once to the
Secretary of the Local Committee under
Although. g stanling LocaT Un
Committee.
which they are enrolled. Do not forget
the address of the Secretary
Name in full
Beek Luvenic brene
If married, give husband's name
Permanent
address morning Seen, lowe
Saratoga Springs
Probable address for the next year Skidmore Colleys/furstory Spring)
Telephone No. 1880
n.y.
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 Buth Morning Seen lown ( mattern
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 good
Would you respond to an emergency call in event of epidemic, disaster, war, etc. yes
Badge No. 37892
Current date the 1. 1927
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\n&\na\nL\nI\nFORM 1045--REV. 2-24-27\nin\ne.\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nL\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. PRESIDENT\nP.\nMRS, AUGUST BELMONT\nROBERT w. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nMRS, HENRY P. DAVISON\naN\nWILLIAM D. MITCHELL, COUNSELOR\n9\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nCHARLES s. DEWEY, TREASURER\nE. B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D. C.\nJOSEPH c. GREW\n+\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. M. w. IRELAND\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\nMr.\nH\n7\n<\nL\nDear Madam:\nP\nThe National Committee on Red Cross Nursing Service requires us to submit,\n<\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\nB\n(b\n5\nHeadquarters and ask for your cooperation. Please answer the following questions and\ne\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nC\na\nIMPORTANT:\n!\nYours sincerely,\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nHanniette gonkeys\nChairman or\nSecretary\nnurses should report at once to the\nSecretary of the Local Committee under\nAlthough. g stanling LocaT Un\nCommittee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary\nName in full\nBeek Luvenic brene\nIf married, give husband's name\nPermanent\naddress morning Seen, lowe\nSaratoga Springs\nProbable address for the next year Skidmore Colleys/furstory Spring)\nTelephone No. 1880\nn.y.\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 Buth Morning Seen lown ( mattern\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 good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. yes\nBadge No. 37892\nCurrent date the 1. 1927\nNOTE. -- If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}