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Form 1037
Rev. 2-15-28
THE AMERICAN NATIONAL RED CROSS NURSING SERVICE
Application for Enrollment
III
(To be filled out entirely in applicant's handwriting and each question answered fully.)
1.
Name of applicant in full Elizabeth Jannette Longuree
i' , 2
3
2.
Ts.
T
Address in full pown.,Newman, Delifornia
Pres Fabiola Huspital Oakland ealied
V
3. Date of birth Dec 23,1908 Race White Place of birth Nevdesha Kansus
Birthplace of father KansneMother Iowa Citizenship of father american
E
5. How many years have you attended graminar school? 8 High school 4 Normal
4. Are you married, single or a widow? Singland (Are you a citizen of the United States? yes
Private school ? 0 College? O if tutored privately, name subjects covered and length of time
e
lizab
a
6. What languages other than English do you speak; none
7.
those which fluently)
8.
From what hospital training schopl did you receive your diplomal Fabrale
tooth
b
Occupation before entering training school School girl you speak
+
Give City and State Oukland Calif Date of graduation Oct 1930 (3yro)
name
9.
Character
of at hospital: time of graduation General? Elizabeth Special fianity Songure
10.
Yes
11.
Did your training include obstetrics us Care of men ? yra Childrenilla Contagious diseases? yes
Private yes
J.
12. Name and address of superintendent of nurses under whom you received training miss
Daily average number of patients in hospital during training. 50-1751 Length of course 3 years
am Jameson Fabralu Hospital Oubland, Calif
13. If your training as a nurse was received in more than one hospital, give name, location and time
ong
spent in each advanced electives San Francisco Hospital
14. Are you a member of your Alumnae Association? yes
Are you affiliated with the American Nurses Association through membership in Alumnae, Dis-
quili
J
15.
trict and State Associations ? Yes
clations of the state in which you are living at the present time.
Affiliation with the American Nurses' Association means membership in the District and Graduate Nurses' Associa-
16. Give name and address of secretary of at least one of these organizations Lillian L
17. Are you a registered nurse? yes in what State ? Calif Date of A-815
White Ethel move memorial Building OaklandCally
18. Type of work and length of service since graduation:
Private Duty
(Present position)
20. 19. Will you be willing to accept service if the United States becomes involved in war? yes
(a) If interested in accepting service within the near future, indicate choice: R. C. P. H. Nursing,
Veterans' Bureau.
Instructor, Home Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U. S.
(b) Date upon which you will be available for service checked
21. Are you willing to take the oath of allegiance?
22. Give name and permanent address of nearest relative yes or friend, residing in the United States
at once if femingency
(state relationship).
NOTE-Nurses Date who have 1930 had training Signature of nurse Janutle Languree
David Oct 2, Longuree father) nurman Calix
tions reverse side of this blank.
23 and 24 on or experience in Public Hoalth Nursing will, in addition to the above, fill out ques-
To The Local Committee:
C. Application forms after approval and endorsement by Local Committee, with Forms 1244, 1189, and
703. This blank is to be sent to applicant with circular letter Form 1199, together with Forms 2, 1193 and A. R.
1193 should be forwarded to National Headquarters or to the proper Branch Office.
(OVER)
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"ocrText": "I\nForm 1037\nRev. 2-15-28\nTHE AMERICAN NATIONAL RED CROSS NURSING SERVICE\nApplication for Enrollment\nIII\n(To be filled out entirely in applicant's handwriting and each question answered fully.)\n1.\nName of applicant in full Elizabeth Jannette Longuree\ni' , 2\n3\n2.\nTs.\nT\nAddress in full pown.,Newman, Delifornia\nPres Fabiola Huspital Oakland ealied\nV\n3. Date of birth Dec 23,1908 Race White Place of birth Nevdesha Kansus\nBirthplace of father KansneMother Iowa Citizenship of father american\nE\n5. How many years have you attended graminar school? 8 High school 4 Normal\n4. Are you married, single or a widow? Singland (Are you a citizen of the United States? yes\nPrivate school ? 0 College? O if tutored privately, name subjects covered and length of time\ne\nlizab\na\n6. What languages other than English do you speak; none\n7.\nthose which fluently)\n8.\nFrom what hospital training schopl did you receive your diplomal Fabrale\ntooth\nb\nOccupation before entering training school School girl you speak\n+\nGive City and State Oukland Calif Date of graduation Oct 1930 (3yro)\nname\n9.\nCharacter\nof at hospital: time of graduation General? Elizabeth Special fianity Songure\n10.\nYes\n11.\nDid your training include obstetrics us Care of men ? yra Childrenilla Contagious diseases? yes\nPrivate yes\nJ.\n12. Name and address of superintendent of nurses under whom you received training miss\nDaily average number of patients in hospital during training. 50-1751 Length of course 3 years\nam Jameson Fabralu Hospital Oubland, Calif\n13. If your training as a nurse was received in more than one hospital, give name, location and time\nong\nspent in each advanced electives San Francisco Hospital\n14. Are you a member of your Alumnae Association? yes\nAre you affiliated with the American Nurses Association through membership in Alumnae, Dis-\nquili\nJ\n15.\ntrict and State Associations ? Yes\nclations of the state in which you are living at the present time.\nAffiliation with the American Nurses' Association means membership in the District and Graduate Nurses' Associa-\n16. Give name and address of secretary of at least one of these organizations Lillian L\n17. Are you a registered nurse? yes in what State ? Calif Date of A-815\nWhite Ethel move memorial Building OaklandCally\n18. Type of work and length of service since graduation:\nPrivate Duty\n(Present position)\n20. 19. Will you be willing to accept service if the United States becomes involved in war? yes\n(a) If interested in accepting service within the near future, indicate choice: R. C. P. H. Nursing,\nVeterans' Bureau.\nInstructor, Home Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U. S.\n(b) Date upon which you will be available for service checked\n21. Are you willing to take the oath of allegiance?\n22. Give name and permanent address of nearest relative yes or friend, residing in the United States\nat once if femingency\n(state relationship).\nNOTE-Nurses Date who have 1930 had training Signature of nurse Janutle Languree\nDavid Oct 2, Longuree father) nurman Calix\ntions reverse side of this blank.\n23 and 24 on or experience in Public Hoalth Nursing will, in addition to the above, fill out ques-\nTo The Local Committee:\nC. Application forms after approval and endorsement by Local Committee, with Forms 1244, 1189, and\n703. This blank is to be sent to applicant with circular letter Form 1199, together with Forms 2, 1193 and A. R.\n1193 should be forwarded to National Headquarters or to the proper Branch Office.\n(OVER)"
}