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N
n
FORM 1037
REV. JULY 1941
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
I
(To be filled out in applicant's handwriting and each question answered fully)
Helen Miniam nimmer
e
1. Name of applicant in full
If married, give maiden name
2. Permanent address
fare (course address for one'year 5 -Oakweed (Street) Rrive (City) oklahema City QKla.
complical
manning
South Carolina
(County)
(State)
(Street)
(City)
(County)
(State)
4. Name and permanent address of nearest relative or friend residing in the United States:
3
mr These nimmer manning, S.C.
mother
(Name)
(Address)
(Relationship)
/
5. Race
6. Present Marital Status
8. What languages other than English do you
7. Citizenship
speak?
White
Single
Native born
None
German
Negro
Married
Naturalized
Spanish
Scandinavian
Other
Widowed
Non citizen
French
Polish
Divorced
Italian
Other
Nationality
Catholic Sister
9. Date
Birthplace of Syria Mother Sebanan , Ayria
of birth games 1900 Place of birth manning S.C.
Is Father a citizen
Yes
of the United States?
No
10. General education (prior to entering nursing)
Did you graduate from high school
1 Yes If no, how many years of high school do you lack?
No
What college or university education did you have prior to entering nursing?
None or less
1 year;
.2 years;
3 years;
Bachelor's
Master's
e Ph.D.
than 1 year;
Degree;
Degree;
11. Nursing Education:
a. School of nursing from which
graduated st Francer Infirmary (Name)
Charlesten
S . C .
(City)
(State)
Date of graduation Sept
1925
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
QKl. City
City and State
(1) (2) University Hospital
Hospital or Organization
Ped.Firth. specialty may 1- dates new. I
-) 942
(3)
d. Academic study since graduation from School of Nursing:
6'm
Number of full time
Number of
College or University
City and State
academic years
points
(1)
2
(2)
(3)
e. Check all degrees obtained
. Bachelor's
Master's
e 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
Public Health
Non nursing (specify)
Other (specify)
(OVER)

Page data

Page: 17
Source index: 0
Type: photo
Media ID: 434b27c60c142c0c
Size: unknown

Document data

ID: 2662041
Core: doc
Type: document

DTO data

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Document identity

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Document source extras

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        "logicalDate": "1945-10-20",
        "month": 10,
        "year": 1945
    },
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Page context

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    "ocrText": "N\nn\nFORM 1037\nREV. JULY 1941\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\nI\n(To be filled out in applicant's handwriting and each question answered fully)\nHelen Miniam nimmer\ne\n1. Name of applicant in full\nIf married, give maiden name\n2. Permanent address\nfare (course address for one'year 5 -Oakweed (Street) Rrive (City) oklahema City QKla.\ncomplical\nmanning\nSouth Carolina\n(County)\n(State)\n(Street)\n(City)\n(County)\n(State)\n4. Name and permanent address of nearest relative or friend residing in the United States:\n3\nmr These nimmer manning, S.C.\nmother\n(Name)\n(Address)\n(Relationship)\n/\n5. Race\n6. Present Marital Status\n8. What languages other than English do you\n7. Citizenship\nspeak?\nWhite\nSingle\nNative born\nNone\nGerman\nNegro\nMarried\nNaturalized\nSpanish\nScandinavian\nOther\nWidowed\nNon citizen\nFrench\nPolish\nDivorced\nItalian\nOther\nNationality\nCatholic Sister\n9. Date\nBirthplace of Syria Mother Sebanan , Ayria\nof birth games 1900 Place of birth manning S.C.\nIs Father a citizen\nYes\nof the United States?\nNo\n10. General education (prior to entering nursing)\nDid you graduate from high school\n1 Yes If no, how many years of high school do you lack?\nNo\nWhat college or university education did you have prior to entering nursing?\nNone or less\n1 year;\n.2 years;\n3 years;\nBachelor's\nMaster's\ne Ph.D.\nthan 1 year;\nDegree;\nDegree;\n11. Nursing Education:\na. School of nursing from which\ngraduated st Francer Infirmary (Name)\nCharlesten\nS . C .\n(City)\n(State)\nDate of graduation Sept\n1925\nLength 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\nQKl. City\nCity and State\n(1) (2) University Hospital\nHospital or Organization\nPed.Firth. specialty may 1- dates new. I\n-) 942\n(3)\nd. Academic study since graduation from School of Nursing:\n6'm\nNumber of full time\nNumber of\nCollege or University\nCity and State\nacademic years\npoints\n(1)\n2\n(2)\n(3)\ne. Check all degrees obtained\n. Bachelor's\nMaster's\ne Ph.D.\n7 Certificate in Public Health\nsubsequent to entering training:\nDegree;\nDegree;\nNursing\nf. In which major field was your academic study?\n1\nInstitutional\nPublic Health\nNon nursing (specify)\nOther (specify)\n(OVER)"
}

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