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FORM 1045--REV. 2-24-27
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE. PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
MRS, AUGUST BELMONT
ROBERT w. DE FOREST, VICE PRESIDENT
1
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
MABEL T. BOARDMAN
WILLIAM D. MITCHELL, COUNSELOR
MRS, HENRY P. DAVISON
CHARLES s. DEWEY, TREASURER
NATIONAL HEADQUARTERS
CHARLES s. DEWEY
E.B. DOUGLAS
MABEL T. BOARDMAN. SECRETARY
WASHINGTON. D. c.
JOSEPH c. GREW
MRS. FRANK v. HAMMAR
HERBERT HOOVER
NATIONAL EXECUTIVE OFFICERS
MAJ. GEN. M. w. IRELAND
WILLIAM D. MITCHELL
JOHN BARTON PAYNE, CHAIRMAN
w.w. MORROW
JAMES L. FIESER, VICE CHAIRMAN
GUSTAVUS D. POPE
MRS. HENRY R. REA
ERNEST P. BICKNELL. VICE CHAIRMAN
JOHN D. RYAN
GEORGE E. SCOTT
a
REAR ADMIRAL E. R. STITT
5
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in the enclosed envelope, at the earliest possible date.
IMPORTANT:
Yours sincerely, (MRS.) LUCY RYDER JARDON,
In order to render prompt service
SECRETARY, LOCAL COMMITTEE
Chairman or
in time of disaster, enrolled Red Cross
RED CROSS NURSING SERVICE
130 STREET
Secretary.
nurses should report at once to the
Secretary of the Local Committee under
BROOKLYN. N. Y,
Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Name in full Jane Eligabeth Hitchcock
If married, give husband's name
Permanent address 71 Willow St., Brooklyn, n.y.
Probable address for the next year
litto
Telephone No. main, 535 5ipalty J.
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Sister - this Lucy P.Hitchesh 71 Willer SC. Broundlegn
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public
Health Institutional Private Duty Office Nurse Registrar. Teaching
- - - Industrial - -
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No
Have you ever been? yes - ditting war-
Indicate present physical condition good
Would
you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes
Badge No. 6578
Current date april - 15-1927
&
NOTE.--If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrollment will be annulled.
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"ocrText": "I\n+\nFORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nCALVIN COOLIDGE. PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS, AUGUST BELMONT\nROBERT w. DE FOREST, VICE PRESIDENT\n1\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL, COUNSELOR\nMRS, HENRY P. DAVISON\nCHARLES s. DEWEY, TREASURER\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nE.B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D. c.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. M. w. IRELAND\nWILLIAM D. MITCHELL\nJOHN BARTON PAYNE, CHAIRMAN\nw.w. MORROW\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\na\nREAR ADMIRAL E. R. STITT\n5\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely, (MRS.) LUCY RYDER JARDON,\nIn order to render prompt service\nSECRETARY, LOCAL COMMITTEE\nChairman or\nin time of disaster, enrolled Red Cross\nRED CROSS NURSING SERVICE\n130 STREET\nSecretary.\nnurses should report at once to the\nSecretary of the Local Committee under\nBROOKLYN. N. Y,\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Jane Eligabeth Hitchcock\nIf married, give husband's name\nPermanent address 71 Willow St., Brooklyn, n.y.\nProbable address for the next year\nlitto\nTelephone No. main, 535 5ipalty J.\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nSister - this Lucy P.Hitchesh 71 Willer SC. Broundlegn\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth Institutional Private Duty Office Nurse Registrar. Teaching\n- - - Industrial - -\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No\nHave you ever been? yes - ditting war-\nIndicate present physical condition good\nWould\nyou respond to an emergency call in event of epidemic, disaster, war, etc. ? yes\nBadge No. 6578\nCurrent date april - 15-1927\n&\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}