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K
-
AMERICAN RED CROSS
RECEIVED
A
FORM No. 469-(3)
JUN 25 1918
THE AMERICAN RED CROSS
5
OF
ENROLLMENT FORM
rb
M
W
s
Voyage number
From Nursing Department
To
DIVISION OF FILES AND RECORDS,
BUREAU OF PERSONNEL.
Date 5-28-18
Approved Clara D. rey's
1. Name
Kloman. Agnes Pickett,
2. Address 915--3nd Ava, Fargo., N.D
3. Temporary address, if any
4. Going to what countries
France
5. Nature of work Nursing, N-5
6. Suggested rank
7. Length of stay (six months or over?)
July
17
8. Proposed approximate date of departure June 15th Booked any Sailed
9. Cable number in compliance with which above is being sent Swan schedule
10. Is appointee volunteer?
No
Chargeable to
Appropriation No.
11. If not volunteer, what salary per month is promised? $ 60.00
12. To begin June 10th
13. What allowance, if any, for transportation in United States? $ Yea, both ways
14. What allowance, if any, for transportation (steamship) ? $
Yes, both ways
15. What allowance, if any, for living expenses prior to departure? $ 4.00 a day for time in New York
16. What allowance, if any, for uniform equipment? $ Requisitioned at New York Office
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?
KSM
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
PASSPORT BUREAU,
WASHINGTON, D. c.
DEPARTMENT OF STATE,
1423 NEW YORK AVENUE,
WASHINGTON, D. C.
of
appointed
in the service of the American National Red Cross, expects to sail
Page data
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- Source index
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- Type
- photo
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Document data
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- Core
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"ocrText": "K\n-\nAMERICAN RED CROSS\nRECEIVED\nA\nFORM No. 469-(3)\nJUN 25 1918\nTHE AMERICAN RED CROSS\n5\nOF\nENROLLMENT FORM\nrb\nM\nW\ns\nVoyage number\nFrom Nursing Department\nTo\nDIVISION OF FILES AND RECORDS,\nBUREAU OF PERSONNEL.\nDate 5-28-18\nApproved Clara D. rey's\n1. Name\nKloman. Agnes Pickett,\n2. Address 915--3nd Ava, Fargo., N.D\n3. Temporary address, if any\n4. Going to what countries\nFrance\n5. Nature of work Nursing, N-5\n6. Suggested rank\n7. Length of stay (six months or over?)\nJuly\n17\n8. Proposed approximate date of departure June 15th Booked any Sailed\n9. Cable number in compliance with which above is being sent Swan schedule\n10. Is appointee volunteer?\nNo\nChargeable to\nAppropriation No.\n11. If not volunteer, what salary per month is promised? $ 60.00\n12. To begin June 10th\n13. What allowance, if any, for transportation in United States? $ Yea, both ways\n14. What allowance, if any, for transportation (steamship) ? $\nYes, both ways\n15. What allowance, if any, for living expenses prior to departure? $ 4.00 a day for time in New York\n16. What allowance, if any, for uniform equipment? $ Requisitioned at New York Office\n17. What allowance, if any, for living expenses abroad? $ Yes, 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?\nKSM\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nPASSPORT BUREAU,\nWASHINGTON, D. c.\nDEPARTMENT OF STATE,\n1423 NEW YORK AVENUE,\nWASHINGTON, D. C.\nof\nappointed\nin the service of the American National Red Cross, expects to sail"
}