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Form 1037
4-23-24
THE AMERICAN NATIONAL RED CROSS NURSING SERVICE
Application for Enrollment
(To be filled out entirely in applicant's handwriting and each question answered fully.)
1.
Name of applicant in full Gertrude Kalherine Lyons (mrs.)
Mrs
TS.
2426 Blaisdell avenue
2.
Address in full minneapolis minnesota
3. Date of birth 1888
Race w
Place of birth minnesota
G
Birthplace of father Belguim Mother Canada
Citizenship of
father U.S.
e.
4. Are you married, single or/a widow? m. Are you a citizen of the United States ? Viee
5. How many years have you attended grammar school ? 8 High school ? 4 Normal school
+
Private school ?
College ? 2 1/2 if tutored privately, name subjects covered and length of time
6. What languages other than English do you speak?
none
(Underline those which you speak fluently)
8. From what hospital training school did you receive your diploma ? St. Joseph's Hospital
7. Occupation before entering training school
student
City and State st Paul, minnesota
Date of graduation
1910
Give name at time of graduation Gertrude Katherine Billion
Character of hospital: General?
-
Special
-
9.
Private ?
+
10. Did your training include obstetrics ? yes Care of men ? yes Children ? yes Contagious diseases ? Tob
11. Daily average number of patients in hospital during training 125 Length of course 3 yrs.
a
12.
Name and address of superintendent of nurses under whom you received training Sister John
+
St. Josephs Hospital st Paul minnessta
5
13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each
e
14. Of what nursing organizations are you a member ? st. Josrepakis Hospital Alumni Association
minn State nursing Association
15. Which, if any, is affiliated with the American Nurses' Association ?
new
16. Give name and address of secretary of at least one of these organizations miss Helen Kappec,
17. Are you a registered nurse yes in what State ? minn Date of registration 1910 Number 719
St Josephs Hospital St. Paul. minm-
18. Type of work and length of service since graduation:
Six months of private duty- Here keeper for ten years.
Helped in the management of a farm for five of fire
years.
(Present position)
just completed comes at F.l. Columbia University
19.
Will you be willing to accept active service if the United States becomes involved in war? yes
20. (a) If interested in accepting service within the near future, indicate choice: R. C.P. H. Nursing, Instructor,
Home Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U. S. Veterans Bureau.
which 2° will be available Nov-5-ch
2.
(b) Date upon you
22. 21. Name and permanent address of near relative (give if relationship) mr. H- Billern (father)
Are you willing to take the oath of allegiance ?
Sincy Falls So Dakota
Date Oct-27-1924
Signature of nurse Sertrude Katherine Lyon ms
NOTE -Nurses who have had training or experience in Public Health Nursing will, in addition to the above, fill out questions
I
23 and 24 on reverse side of this blank.
To The Committee:
This blank is to be sent to applicant with circular letter Form 1199, together with Forms 2, 1193 and A. R. C.
703. Application forms after approval and endorsement by Local committee, with Forms 1244, 1189, 1193 should
D
be forwarded to the Director of the Nursing Service in your Division Office.
BOBTIC HEVP.tH
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"ocrText": "0\nns\nS\nForm 1037\n4-23-24\nTHE AMERICAN NATIONAL RED CROSS NURSING SERVICE\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully.)\n1.\nName of applicant in full Gertrude Kalherine Lyons (mrs.)\nMrs\nTS.\n2426 Blaisdell avenue\n2.\nAddress in full minneapolis minnesota\n3. Date of birth 1888\nRace w\nPlace of birth minnesota\nG\nBirthplace of father Belguim Mother Canada\nCitizenship of\nfather U.S.\ne.\n4. Are you married, single or/a widow? m. Are you a citizen of the United States ? Viee\n5. How many years have you attended grammar school ? 8 High school ? 4 Normal school\n+\nPrivate school ?\nCollege ? 2 1/2 if tutored privately, name subjects covered and length of time\n6. What languages other than English do you speak?\nnone\n(Underline those which you speak fluently)\n8. From what hospital training school did you receive your diploma ? St. Joseph's Hospital\n7. Occupation before entering training school\nstudent\nCity and State st Paul, minnesota\nDate of graduation\n1910\nGive name at time of graduation Gertrude Katherine Billion\nCharacter of hospital: General?\n-\nSpecial\n-\n9.\nPrivate ?\n+\n10. Did your training include obstetrics ? yes Care of men ? yes Children ? yes Contagious diseases ? Tob\n11. Daily average number of patients in hospital during training 125 Length of course 3 yrs.\na\n12.\nName and address of superintendent of nurses under whom you received training Sister John\n+\nSt. Josephs Hospital st Paul minnessta\n5\n13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each\ne\n14. Of what nursing organizations are you a member ? st. Josrepakis Hospital Alumni Association\nminn State nursing Association\n15. Which, if any, is affiliated with the American Nurses' Association ?\nnew\n16. Give name and address of secretary of at least one of these organizations miss Helen Kappec,\n17. Are you a registered nurse yes in what State ? minn Date of registration 1910 Number 719\nSt Josephs Hospital St. Paul. minm-\n18. Type of work and length of service since graduation:\nSix months of private duty- Here keeper for ten years.\nHelped in the management of a farm for five of fire\nyears.\n(Present position)\njust completed comes at F.l. Columbia University\n19.\nWill you be willing to accept active service if the United States becomes involved in war? yes\n20. (a) If interested in accepting service within the near future, indicate choice: R. C.P. H. Nursing, Instructor,\nHome Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U. S. Veterans Bureau.\nwhich 2° will be available Nov-5-ch\n2.\n(b) Date upon you\n22. 21. Name and permanent address of near relative (give if relationship) mr. H- Billern (father)\nAre you willing to take the oath of allegiance ?\nSincy Falls So Dakota\nDate Oct-27-1924\nSignature of nurse Sertrude Katherine Lyon ms\nNOTE -Nurses who have had training or experience in Public Health Nursing will, in addition to the above, fill out questions\nI\n23 and 24 on reverse side of this blank.\nTo The Committee:\nThis blank is to be sent to applicant with circular letter Form 1199, together with Forms 2, 1193 and A. R. C.\n703. Application forms after approval and endorsement by Local committee, with Forms 1244, 1189, 1193 should\nD\nbe forwarded to the Director of the Nursing Service in your Division Office.\nBOBTIC HEVP.tH"
}