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Form No. 200 Revised 2-15-18 QUINTUPLICATE AMERICAN RED CROSS SERVICE ENROLLMENT APPLICATION No. (OTHER THAN AS DOCTOR, SURGEON, OR NURSE) Date The questions should be answered as fully as possible, especially when an application for a passport may later be necessary. All answers must be in handwriting of applicant. I. Name in full. Sexo M Gray Telephone No. Intervele 575 2. Present Address 0/0 Mrs. Snodden, 1504 Grotono Pirk, E. (Number and Street) (City) (State) (a) If any changes of residence since August I, 1914, give these in full with dates Jrn. He Y.S. Hoop. Aus. 1.14 to Aug. 136 Union Homp.Drom to Prepent Jens pdd.since (b) What is your present business or profession? (Be specific.) Private Unreing (c) What previous business or professional experience have you had, stating nature, places and principal dates thereof? Worked as undergraduate of prection1 marge in Unit Hosp. 2456 Valentine Ave., Bronx. (d) Have you ever lived in Europe? If so, give names of European countries in which you have resided and respective dates of residence in each. Yes. Iralend from birth until 23 yerre old (e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits. (f) Since August I, 1914, have you applied for a United States passport? If so, state whether application was granted, denied or withdrawn. lie 3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state militia ne (a) Have you ever been examined for war service? If so, state when, where and, if possible, name of examin- ing official. Yes. June 4th, 1918 in H.Y.ORty.DreBo Foote, U.S.M., 119 E. 40th. (b) Were you accepted, rejected, or is result of examination pending? N.Y.City Accepted by Red Gross 4. Date of birth 1886 Dec. as (a) Place of birth Ireland Year Month Day (b) Full name of father John Time Gray (c) Birthplace of father Ireland (d) Nationality of father British (e) If father foreign born, whether naturalized and when Never asme to U.S. (f) Full maiden name of mother Annie Ruddy (g) Birthplace of mother Ireland (h) Nationality of mother British Never erne to U. S. (i) If mother foreign born, whether naturalized and when (j) Full name and nationality of paternal grandfather Richard Gray, British (k) Full maiden name and nationality of paternal grandmother Margaret Hill 1 William Rieddy (1) Full name and nationality of maternal grandfather Sera Ardrey (m) Full maiden name and nationality of maternal grandmother (n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State nature and places of employment of each of such relatives not now in such war service. ther and moth and sisters. None. (o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States, specifying which ally in every case. None

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34
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0
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photo
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Document identity
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Page context
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    "ocrText": "Form No. 200\nRevised 2-15-18\nQUINTUPLICATE\nAMERICAN RED CROSS\nSERVICE ENROLLMENT APPLICATION\nNo.\n(OTHER THAN AS DOCTOR, SURGEON, OR NURSE)\nDate\nThe questions should be answered as fully as possible, especially when an application for a passport may later be necessary.\nAll answers must be in handwriting of applicant.\nI. Name in full. Sexo M Gray\nTelephone No. Intervele 575\n2. Present Address 0/0 Mrs. Snodden, 1504 Grotono Pirk, E.\n(Number and Street)\n(City)\n(State)\n(a) If any changes of residence since August I, 1914, give these in full with dates Jrn.\nHe Y.S. Hoop. Aus. 1.14 to Aug. 136 Union Homp.Drom to Prepent Jens pdd.since\n(b) What is your present business or profession? (Be specific.)\nPrivate Unreing\n(c) What previous business or professional experience have you had, stating nature, places and principal dates\nthereof?\nWorked as undergraduate of prection1 marge in Unit Hosp.\n2456 Valentine Ave., Bronx.\n(d) Have you ever lived in Europe? If so, give names of European countries in which you have resided\nand respective dates of residence in each.\nYes. Iralend from birth until 23 yerre old\n(e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits.\n(f) Since August I, 1914, have you applied for a United States passport? If so, state whether application\nwas granted, denied or withdrawn.\nlie\n3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state militia\nne\n(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of examin-\ning official.\nYes. June 4th, 1918 in H.Y.ORty.DreBo Foote, U.S.M., 119 E. 40th.\n(b) Were you accepted, rejected, or is result of examination pending?\nN.Y.City\nAccepted by Red Gross\n4. Date of birth 1886\nDec.\nas\n(a) Place of birth Ireland\nYear\nMonth\nDay\n(b) Full name of father John Time Gray\n(c) Birthplace of father Ireland\n(d) Nationality of father British\n(e) If father foreign born, whether naturalized and when Never asme to U.S.\n(f) Full maiden name of mother Annie Ruddy\n(g) Birthplace of mother Ireland\n(h) Nationality of mother\nBritish\nNever erne to U. S.\n(i) If mother foreign born, whether naturalized and when\n(j) Full name and nationality of paternal grandfather Richard Gray, British\n(k) Full maiden name and nationality of paternal grandmother Margaret Hill\n1\nWilliam Rieddy\n(1) Full name and nationality of maternal grandfather\nSera Ardrey\n(m) Full maiden name and nationality of maternal grandmother\n(n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if\nany, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State\nnature and places of employment of each of such relatives not now in such war service.\nther and moth and sisters.\nNone.\n(o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States,\nspecifying which ally in every case.\nNone"
}