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N
D
etc.
e.
(p) Names of all relatives nearer than second cousins in the war service of the United States Government.
Lawton Moore
Bartlet Byers
5. If foreign born, give date and court of your naturalization
6. Single, married, widow, or widower Single
(a) Number of dependents None
(b) Full name and address of nearest relative or friend Mrs. Harold C. Allen
(c) Full name of wife before marriage; or husband
Mar
3
505 South 46th Street, West Phildelphia, Pa.
(d) Birthplace of wife or husband
(e) Nationality of wife or husband
(f) Birthplace and nationality of father of wife or husband
(g) Birthplace and nationality of mother of wife or husband
7. Kind of service preferred. (Specify.
Public Health Work
8. Would you enter foreign service? yes (a) If so, in what country or countries? Any
(b) Describe fully any experience you have ever had in service of the American Red Cross.
9. Would you serve without pay and defray all of your necessary expenses?
(a) With only expenses defrayed for you?
(b) If not, what minimum salary would you require in addition to the defraying of your expenses?
IO. What University or College attended?
None
Year graduated
II. Can you speak French fluently? No
(a) If not, to what degree, if any? A few words
(b) Can you translate French easily? No
(c). If not, to what degree, if any?
I2. What other foreign languages do you speak? German a little,
(a) State extent of your knowledge of each
13. As references, give names and addresses of three American citizens not related to you.
Mrs. Frances Tieman, 82 Arlingtonnavenue, East range, N. J.
Miss Bessie M. Millman, Orange Memorial Hospital, Orange, N. J.
Mrs. Spencer D. Smith, 224 Linwood Avenue, Upper Montclair, N.J.2
14. Give names and addresses of all patriotic, beneficial, social or other form of clubs, societies or other organizations
based on race, nationality, etc., to which you belong or have at any time belonged, since August I, 1914.
Alumnae Assn. Training School, St. for Children. Young
Peoples Club, The Mission of the Redeemer (Church) 207th St. N.Y.C.
15. If enrolled in service, name earliest date you could take up work
June 1, 1918.
I hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.
Marjorie L. Work
R.N.
Signature.
Division Personnel Committee examining application. Atlantic
Date of report May 29, 1918.
Report of Committee. (Be specific.) Mrs. Matthews vouches for absolutely, is sure
that there is no question as to Miss Works! loyalty.
Date of receipt at National Headquarters
Checked by
Commeats:
Page data
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- Type
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Document data
- ID
- 2661350
- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "N\nD\netc.\ne.\n(p) Names of all relatives nearer than second cousins in the war service of the United States Government.\nLawton Moore\nBartlet Byers\n5. If foreign born, give date and court of your naturalization\n6. Single, married, widow, or widower Single\n(a) Number of dependents None\n(b) Full name and address of nearest relative or friend Mrs. Harold C. Allen\n(c) Full name of wife before marriage; or husband\nMar\n3\n505 South 46th Street, West Phildelphia, Pa.\n(d) Birthplace of wife or husband\n(e) Nationality of wife or husband\n(f) Birthplace and nationality of father of wife or husband\n(g) Birthplace and nationality of mother of wife or husband\n7. Kind of service preferred. (Specify.\nPublic Health Work\n8. Would you enter foreign service? yes (a) If so, in what country or countries? Any\n(b) Describe fully any experience you have ever had in service of the American Red Cross.\n9. Would you serve without pay and defray all of your necessary expenses?\n(a) With only expenses defrayed for you?\n(b) If not, what minimum salary would you require in addition to the defraying of your expenses?\nIO. What University or College attended?\nNone\nYear graduated\nII. Can you speak French fluently? No\n(a) If not, to what degree, if any? A few words\n(b) Can you translate French easily? No\n(c). If not, to what degree, if any?\nI2. What other foreign languages do you speak? German a little,\n(a) State extent of your knowledge of each\n13. As references, give names and addresses of three American citizens not related to you.\nMrs. Frances Tieman, 82 Arlingtonnavenue, East range, N. J.\nMiss Bessie M. Millman, Orange Memorial Hospital, Orange, N. J.\nMrs. Spencer D. Smith, 224 Linwood Avenue, Upper Montclair, N.J.2\n14. Give names and addresses of all patriotic, beneficial, social or other form of clubs, societies or other organizations\nbased on race, nationality, etc., to which you belong or have at any time belonged, since August I, 1914.\nAlumnae Assn. Training School, St. for Children. Young\nPeoples Club, The Mission of the Redeemer (Church) 207th St. N.Y.C.\n15. If enrolled in service, name earliest date you could take up work\nJune 1, 1918.\nI hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.\nMarjorie L. Work\nR.N.\nSignature.\nDivision Personnel Committee examining application. Atlantic\nDate of report May 29, 1918.\nReport of Committee. (Be specific.) Mrs. Matthews vouches for absolutely, is sure\nthat there is no question as to Miss Works! loyalty.\nDate of receipt at National Headquarters\nChecked by\nCommeats:"
}