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15. State the names of all relatives by blood or marriage nearer than second cousins in the war service of the
United States or any of its allies, specifying which ally in every case and the branch of service in which
enrolled Harold Bruner brother
in
Our Service of United States
16. (a) Are you a member of a religious sect or organization whose creed forbids you to participate in war in
any form his
If so, state its name
(b) Give names and addresses of all patriotic, beneficial and social organizations based on race, nationality,
etc., to which you have at any time belonged none
17. (a) Are your father, husband, brother or son enrolled in, or about to enroll in foreign service of the Ameri-
can Red Cross, Y. M. C. A., K. of C., or other similar organizations no.
(b) If so, state the name of any such organization
18. What university or college attended ? none
Year graduated
19. Can you speak French fluently ? no (a) If not, to what degree, if any ? none
(b) Can you translate French easily ? no (c) If not, to what degree, if any none
20. What other foreign languages do you speak
home
State extent of your knowledge of each
-
21. As references, give names and addresses of three American citizens not related to you
Frank Dr PH Guerena Humboldt Bank Building Santa Roaa San Francisco
memeray - Santa Rosa is ll.
22.
miss Elizabeth dotogue Lane Hospital Sam Francisco
(a) Kind of service preferred Foreign service in Siberia
(b) What do you consider your qualifications particularly fitting you for this service? Professional
experience n B H as # a nurse 2 - military service with
(c) Describe fully any experience you have ever had in the service of the Red Cross none.
23. Would you enter foreign service yes (a) In any country or countries where required?
24. (a) Would you serve without pay and defray all of your necessary personal expenses no
yes.
(b) If unable to serve as full self sustaining volunteer, check following items you would require met by Red
Cross :
Allowance for living abroad yes
Allowance for living prior to departure
no
Allowance or requisition for uniform and equipment yes
Allowance for transportation in United States and return no
Allowance for transportation overseas to destination and return yes
(c) If Red Cross made adequate allowance for your expenses in the service, as per 24-b, what specific amount
would you require in addition ? 70 per month
25. If enrolled in service (a) name earliest date you could take up work when called (b) Minimum term for which
you would serve
year
I
hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.
Signed Hazel G. Brumer
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"ocrText": "15. State the names of all relatives by blood or marriage nearer than second cousins in the war service of the\nUnited States or any of its allies, specifying which ally in every case and the branch of service in which\nenrolled Harold Bruner brother\nin\nOur Service of United States\n16. (a) Are you a member of a religious sect or organization whose creed forbids you to participate in war in\nany form his\nIf so, state its name\n(b) Give names and addresses of all patriotic, beneficial and social organizations based on race, nationality,\netc., to which you have at any time belonged none\n17. (a) Are your father, husband, brother or son enrolled in, or about to enroll in foreign service of the Ameri-\ncan Red Cross, Y. M. C. A., K. of C., or other similar organizations no.\n(b) If so, state the name of any such organization\n18. What university or college attended ? none\nYear graduated\n19. Can you speak French fluently ? no (a) If not, to what degree, if any ? none\n(b) Can you translate French easily ? no (c) If not, to what degree, if any none\n20. What other foreign languages do you speak\nhome\nState extent of your knowledge of each\n-\n21. As references, give names and addresses of three American citizens not related to you\nFrank Dr PH Guerena Humboldt Bank Building Santa Roaa San Francisco\nmemeray - Santa Rosa is ll.\n22.\nmiss Elizabeth dotogue Lane Hospital Sam Francisco\n(a) Kind of service preferred Foreign service in Siberia\n(b) What do you consider your qualifications particularly fitting you for this service? Professional\nexperience n B H as # a nurse 2 - military service with\n(c) Describe fully any experience you have ever had in the service of the Red Cross none.\n23. Would you enter foreign service yes (a) In any country or countries where required?\n24. (a) Would you serve without pay and defray all of your necessary personal expenses no\nyes.\n(b) If unable to serve as full self sustaining volunteer, check following items you would require met by Red\nCross :\nAllowance for living abroad yes\nAllowance for living prior to departure\nno\nAllowance or requisition for uniform and equipment yes\nAllowance for transportation in United States and return no\nAllowance for transportation overseas to destination and return yes\n(c) If Red Cross made adequate allowance for your expenses in the service, as per 24-b, what specific amount\nwould you require in addition ? 70 per month\n25. If enrolled in service (a) name earliest date you could take up work when called (b) Minimum term for which\nyou would serve\nyear\nI\nhereby certify that the answers to the above questions are correct to the best of my knowledge and belief.\nSigned Hazel G. Brumer"
}