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Z
I
ee
e
ar
I
E
for
C
THE AMERICAN NATIONAL RED CROSS NURSING SERVICE
Form 1037
Rev.
2-4-35.
ZR
Application for Enrollment
(To be filled out entirely in applicant's handwriting and each question answered fully.)
ja
Name of applicant in full Mellie Francls Labrum
eille
1.
Mrs
If married, give maiden name
rs.
2.
Permanent address in full.
1445 Gardner St Hollywood, Calif
Probable address for one year 2340 clay St. Son Francisco
3. Date of birth august (Month) (Day) 29,1914 (Year) Race. white Place of birth Hollywood
N
5
Birthplace of father fathert, Kansas Mother Hubert, of father american
(b
Are you a citizen of the United States? yrs
c
4.
=
=
-
Are you single, married, a widow, or divorced? single
5. How many years have you attended Grammar School? 8 High school? 4 Normal school?
e,
Private school?
College? 1 If tutored privately, name subjects covered and length
of time
6.
What languages other than English do you speak?
L
F.
(Underline those which you speak fluently)
7.
Occupation before entering school of nursing school gial
a
8.
From what school of nursing did you receive your diploma? stanfad School nursing
City and State. San Francisco, Calif Date of graduation MN.26,1936
(P.)
9.
Character of Hospital: General? general Special?
Private?
10. Did your training include medical and surgical care of men? yes Of women! ?. yes
Pediatrics? yes Obstetrics? yes Communicable diseases? no
11.
Daily average number of patients in hospital during training. 280 Length of course 3 yrs
12. Name and address of director of school of nursing under whom you received training
miss Edith Smith, 2340 clay ld Sun Francisco
13.
If your education as a nurse was received in more than one hospital, give name, location and
time spent in each
14.
Are you a member of your Alumnae Association? yes
15. Are you affiliated with the American Nurses' Association through membership in District and
State Associations? yes
Affiliation with the American Marses' Association means active membership in the District and Graduate Nurses' Associations
of the state in which you are living at the present time.
16.
Give name and address of secretary of the District or State Association of which you are a
member Camille younge 1155 Pine Rt, San Francisco
17. Are you a registered nurse? yes In what State Calif Date of registration/-?-37: Number B5114
18. Type of work and length of service since graduation:
General duty for b weeks
32
II non ga su OL esse Aom equesgou sug
19. Are you willing to accept service if the United States becomes involved in war? yrs
Or, service with the American Red Cross in time of disaster or great emergency? yes
20. Are you willing to take the oath of allegiance? yes
21. Are you a qualified public health nurse, or teacher?
no
If so, please answer the questions on the reverse side of this blank.
pt
22.
Give name and permanent address of nearest relative or friend, residing in the United States
(state relationship).
ma alfred Labrum 1445 Garner st Hallywood
6
Date jan 26,1937 Signature of Nurse Franusfabrum
(OVER)
2
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Document data
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"ocrText": "Z\nI\nee\ne\nar\nI\nE\nfor\nC\nTHE AMERICAN NATIONAL RED CROSS NURSING SERVICE\nForm 1037\nRev.\n2-4-35.\nZR\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully.)\nja\nName of applicant in full Mellie Francls Labrum\neille\n1.\nMrs\nIf married, give maiden name\nrs.\n2.\nPermanent address in full.\n1445 Gardner St Hollywood, Calif\nProbable address for one year 2340 clay St. Son Francisco\n3. Date of birth august (Month) (Day) 29,1914 (Year) Race. white Place of birth Hollywood\nN\n5\nBirthplace of father fathert, Kansas Mother Hubert, of father american\n(b\nAre you a citizen of the United States? yrs\nc\n4.\n=\n=\n-\nAre you single, married, a widow, or divorced? single\n5. How many years have you attended Grammar School? 8 High school? 4 Normal school?\ne,\nPrivate school?\nCollege? 1 If tutored privately, name subjects covered and length\nof time\n6.\nWhat languages other than English do you speak?\nL\nF.\n(Underline those which you speak fluently)\n7.\nOccupation before entering school of nursing school gial\na\n8.\nFrom what school of nursing did you receive your diploma? stanfad School nursing\nCity and State. San Francisco, Calif Date of graduation MN.26,1936\n(P.)\n9.\nCharacter of Hospital: General? general Special?\nPrivate?\n10. Did your training include medical and surgical care of men? yes Of women! ?. yes\nPediatrics? yes Obstetrics? yes Communicable diseases? no\n11.\nDaily average number of patients in hospital during training. 280 Length of course 3 yrs\n12. Name and address of director of school of nursing under whom you received training\nmiss Edith Smith, 2340 clay ld Sun Francisco\n13.\nIf your education as a nurse was received in more than one hospital, give name, location and\ntime spent in each\n14.\nAre you a member of your Alumnae Association? yes\n15. Are you affiliated with the American Nurses' Association through membership in District and\nState Associations? yes\nAffiliation with the American Marses' Association means active membership in the District and Graduate Nurses' Associations\nof the state in which you are living at the present time.\n16.\nGive name and address of secretary of the District or State Association of which you are a\nmember Camille younge 1155 Pine Rt, San Francisco\n17. Are you a registered nurse? yes In what State Calif Date of registration/-?-37: Number B5114\n18. Type of work and length of service since graduation:\nGeneral duty for b weeks\n32\nII non ga su OL esse Aom equesgou sug\n19. Are you willing to accept service if the United States becomes involved in war? yrs\nOr, service with the American Red Cross in time of disaster or great emergency? yes\n20. Are you willing to take the oath of allegiance? yes\n21. Are you a qualified public health nurse, or teacher?\nno\nIf so, please answer the questions on the reverse side of this blank.\npt\n22.\nGive name and permanent address of nearest relative or friend, residing in the United States\n(state relationship).\nma alfred Labrum 1445 Garner st Hallywood\n6\nDate jan 26,1937 Signature of Nurse Franusfabrum\n(OVER)\n2"
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