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FORM 1045 REV. OCT. 1943 AMERICAN RED CROSS NURSING SERVICE ANNUAL QUESTIONNAIRE-1944 vistitim tot l'eveiled Red Cross If you have changed your last name Badge number 6438 since contacting us, please check here. Name in full MULVILLE Josephine AngeLA (last) (first) (middle) Tel. NO.GARRISON-0192 If married, give maiden name Date of birth 3/21/1981 Marital status Single Husband's name (single, married, widowed, divorced) Permanent address 402 disiden Lt billedly fith mafarh man (street) (city) (county) (state) D Present address n. Bestal19 suffell mas (street) (city) (county) (state) Notify national headquarters immediately if you change your address. Give name and address of nearest relative or friend in the United States: num (name) Leoper flendining, (address) 402Lander it ballendefill (relationship) has Dentis Are you employed in nursing at the present time? Yes No If employed, check the type of work you are doing and fill in below the title of your position and the name and address of the agency or institution: Institutional Public Health Industrial Private Duty Other supervistration dast Hospital If not employed, what type of nursing would you prefer to render? IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX AVAILABILITY FOR SERVICE WITH THE ARMED FORCES Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40. For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She may be single or married, but if married she must have no dependents under 14 years of age. If eligible and not already in service with the armed forces, are you : Immediately available? Available in the near future? (specify date) Not available, for the following reason ? Can age (specify) Do you have any dependents under 14 years of age? Yes No AVAILABILITY FOR SERVICE WITH CIVILIANS If qualified and not already doing so, will you be available: To teach Red Cross Home Nursing classes? To teach volunteer nurse's aides? To take a Red Cross emergency assignment? To serve overseas caring for civilians? Have you ever served with the Red Cross in a disaster? Yes No If yes, specify type of disaster X

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Document source extras
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Page context
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    "ocrText": "FORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nvistitim\ntot\nl'eveiled\nRed Cross\nIf you have changed your last name\nBadge number 6438\nsince contacting us, please check here.\nName\nin full MULVILLE Josephine AngeLA\n(last)\n(first)\n(middle)\nTel. NO.GARRISON-0192\nIf married, give maiden name\nDate of birth 3/21/1981\nMarital status\nSingle\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 402 disiden Lt billedly fith mafarh\nman\n(street)\n(city)\n(county)\n(state)\nD\nPresent address n. Bestal19 suffell\nmas\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nnum (name) Leoper flendining, (address) 402Lander it ballendefill (relationship) has Dentis\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nsupervistration dast Hospital\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45.\nShe\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you :\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ? Can age\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster\nX"
}