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e
4911
M
FORM No. 469-(2)
THE AMERICAN RED CROSS
U
T
ENROLLMENT FORM
M
W
Voyage number
From
To
THE DIVISION OF TRANSPORTATION,
Nursing Department
BUREAU OF PERSONNEL.
C.h.B
Date
associate
3-26-78
Approval of Director,
Approved
Bureau of Personnel 7.P.K.
Clara Duy
D
1. Name
Hickey, Mrs. Mary
9
2. Address
-
148 ancock St. Soringfield Mass
5
3. Temporary address, if any
es
e
4. Going to what countries
France
5. Nature of work
6. Suggested rank
Infant Welfare
7. Length of stay (six months or over?)
Indefinite
8. Proposed approximate date of departure
April TOth, 1918
Booked Afrs 10
Sailed 424
9. Cable number in compliance with which above is being sent
2170
1703.
10. Is appointee volunteer?
No.
11. If not volunteer, what salary per month is promised? $
12. To begin
60.00
date of salling
13. What allowance, if any, for transportation in United States? $
yes,both ways
14. What allowance, if any, for transportation (steamship)? $
yes, both ways
15. What allowance, if any, for living expenses prior to departure? $
3.00 a day
16. What allowance, if any, for uniform equipment? $
yes, regulation equpment
17. What allowance, if any, for living expenses abroad? $
yes. regulation allowance
18. Is there to be an assignment of part or all of salary?
19. Has the proper form been sent to the Life Extension Institute?
Division of Transportation,
PLEASE LEAVE THE FOLLOWING LINES BLANK.
Correspondence checked:
Note
3/28
Forms
1-2-
11-17-20)
Mailed 3/28/18
Clerk of the
Court at
Application for passport filed
Date
Issued
Reservation
Cancelled
Cabled
Cancelled
Page data
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- Source index
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- Type
- photo
- Media ID
- 9f6230ecbe5c2011
- Size
- unknown
Document data
- ID
- 2661636
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source metadata
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Document source extras
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Page context
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"ocrText": "I\ne\n4911\nM\nFORM No. 469-(2)\nTHE AMERICAN RED CROSS\nU\nT\nENROLLMENT FORM\nM\nW\nVoyage number\nFrom\nTo\nTHE DIVISION OF TRANSPORTATION,\nNursing Department\nBUREAU OF PERSONNEL.\nC.h.B\nDate\nassociate\n3-26-78\nApproval of Director,\nApproved\nBureau of Personnel 7.P.K.\nClara Duy\nD\n1. Name\nHickey, Mrs. Mary\n9\n2. Address\n-\n148 ancock St. Soringfield Mass\n5\n3. Temporary address, if any\nes\ne\n4. Going to what countries\nFrance\n5. Nature of work\n6. Suggested rank\nInfant Welfare\n7. Length of stay (six months or over?)\nIndefinite\n8. Proposed approximate date of departure\nApril TOth, 1918\nBooked Afrs 10\nSailed 424\n9. Cable number in compliance with which above is being sent\n2170\n1703.\n10. Is appointee volunteer?\nNo.\n11. If not volunteer, what salary per month is promised? $\n12. To begin\n60.00\ndate of salling\n13. What allowance, if any, for transportation in United States? $\nyes,both ways\n14. What allowance, if any, for transportation (steamship)? $\nyes, both ways\n15. What allowance, if any, for living expenses prior to departure? $\n3.00 a day\n16. What allowance, if any, for uniform equipment? $\nyes, regulation equpment\n17. What allowance, if any, for living expenses abroad? $\nyes. regulation allowance\n18. Is there to be an assignment of part or all of salary?\n19. Has the proper form been sent to the Life Extension Institute?\nDivision of Transportation,\nPLEASE LEAVE THE FOLLOWING LINES BLANK.\nCorrespondence checked:\nNote\n3/28\nForms\n1-2-\n11-17-20)\nMailed 3/28/18\nClerk of the\nCourt at\nApplication for passport filed\nDate\nIssued\nReservation\nCancelled\nCabled\nCancelled"
}