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FORM 1037 REV. FEB. 1942 AMERICAN RED CROSS APPLICATION FOR ENROLLMENT IN NURSING SERVICE (To be filled out in applicant's handwriting and each question answered fully) 1. Name of applicant in full Betty Jean Koopman If married, give maiden name 2. Permanent address 2314 7th Street Lubbock Lubbock Texas (Street) (City) (County) (State) 3. Probable address for one (Street) nursing, (City) University (County) (State) 4. Name and permanent address of nearest relative or friend residing in the United States: Mrs. w F. Koopman 2314 7th Street Mother (Name) Labbock Telas (Relationship) 5. Race 6. Present Marital Status 7. Citizenship 8. What languages other than English do you speak? 2 White 1 Single 1 Native born 0 None 4 German 4 Negro 2 Married 2 Naturalized 1 Spanish 5 Scandinavian 6 Other 3 Widowed 3 Non citizen 2 French 6 Polish Nationality 4 Divorced 3 Italian 7 Other American 5 Catholic Sister 9. Date of birth NovEmber 4 1918 Place of birth Great Bend, Ks Is father a citizen of the (Month) (Day) (Year) United States? Yes No. Birthplace of father Kansas mother Pennsy /vania 10. General education (prior to entering nursing) : Did you graduate from high school? yes If not, how many years of high school did you have? Have you graduated from high school since entering nursing? Yes No. What college or university education did you have prior to entering nursing? 0 None or less 1 1 year ; 2 2 years ; 3 3 years H. Bachelor's 5 Master's 6 Ph.D. than 1 year ; Degree ; Degree 11. Nursing Education: a. School of nursing from which graduated u. of K. School of Nursing Kansas City Kansas (Name) (City) (State) Date of completion of course October 8 1942 Length of course: 5 years; 3 years ; (Specify other) b. Undergraduate affiliations: Clinical Hospital or Organization City and State specialty No. months (1) (2) (3) c. Postgraduate clinical courses (Do not include academic work or employment.) Clinical Inclusive Hospital or Organization City and State specialty dates (1) (2) (3) d. Academic study since graduation from School of Nursing : Number of full-time Number of College or University City and State academic years points (1) (2) (3) e. Check all degrees obtained 4 Bachelor's 5 Master's 6 Ph.D.; 7 Certificate in Public Health subsequent to entering training Degree ; Degree; Nursing f. In which major field was your academic study ? 1 Institutional 2 Public Health 5 Non nursing (specify) Zoology Other (specify) (OVER)

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Page context
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    "ocrText": "FORM 1037\nREV. FEB. 1942\nAMERICAN RED CROSS\nAPPLICATION FOR ENROLLMENT IN NURSING SERVICE\n(To be filled out in applicant's handwriting and each question answered fully)\n1. Name of applicant in full\nBetty Jean Koopman\nIf married, give maiden name\n2.\nPermanent address 2314 7th Street Lubbock Lubbock Texas\n(Street)\n(City)\n(County)\n(State)\n3. Probable address for one (Street) nursing, (City) University (County) (State)\n4. Name and permanent address of nearest relative or friend residing in the United States:\nMrs. w F. Koopman 2314 7th Street\nMother\n(Name)\nLabbock Telas\n(Relationship)\n5. Race\n6. Present Marital Status\n7. Citizenship\n8. What languages other than English do you\nspeak?\n2 White\n1 Single\n1\nNative born\n0 None\n4 German\n4 Negro\n2 Married\n2 Naturalized\n1 Spanish\n5 Scandinavian\n6 Other\n3 Widowed\n3 Non citizen\n2 French\n6 Polish\nNationality\n4 Divorced\n3 Italian\n7 Other\nAmerican\n5 Catholic Sister\n9. Date of birth NovEmber 4 1918 Place of birth Great Bend, Ks Is father a citizen of the\n(Month)\n(Day)\n(Year)\nUnited States?\nYes\nNo.\nBirthplace of father Kansas\nmother Pennsy /vania\n10. General education (prior to entering nursing) :\nDid you graduate from high school? yes If not, how many years of high school did you have?\nHave you graduated from high school since entering nursing?\nYes\nNo.\nWhat college or university education did you have prior to entering nursing?\n0 None or less\n1 1 year ;\n2 2 years ;\n3 3 years H.\nBachelor's\n5 Master's\n6 Ph.D.\nthan 1 year ;\nDegree ;\nDegree\n11. Nursing Education:\na. School of nursing from which\ngraduated\nu. of K. School of Nursing Kansas City Kansas\n(Name)\n(City)\n(State)\nDate of completion of course October 8 1942 Length of course:\n5 years;\n3 years ;\n(Specify other)\nb. Undergraduate affiliations:\nClinical\nHospital or Organization\nCity and State\nspecialty\nNo. months\n(1)\n(2)\n(3)\nc. Postgraduate clinical courses (Do not include academic work or employment.)\nClinical\nInclusive\nHospital or Organization\nCity and State\nspecialty\ndates\n(1)\n(2)\n(3)\nd. Academic study since graduation from School of Nursing :\nNumber of full-time\nNumber of\nCollege or University\nCity and State\nacademic years\npoints\n(1)\n(2)\n(3)\ne. Check all degrees obtained\n4 Bachelor's\n5 Master's\n6 Ph.D.;\n7 Certificate in Public Health\nsubsequent to entering training\nDegree ;\nDegree;\nNursing\nf. In which major field was your academic study ?\n1 Institutional\n2 Public Health\n5 Non nursing (specify) Zoology\nOther (specify)\n(OVER)"
}