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FORM 1048--REV. 2-24-27
3
CENTRAL COMMITTEE
NATIONAL OFFICERS
JOHN BARTON PAYNE, CHAIRMAN
HERSERT HOOVER, PRESIDENT
MRS. AUGUST BELMONT
ROBERT w. DE FOREST. VICE PRESIDENT
CORNELIUS N. BLISS
TS.
WILLI (M HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
J. REUBEN CLARK, JR.
WILLIAM D. MITCHELL. COUNSELOR
NATIONAL HEADQUARTERS
MRS. HENRY P. DAVISON
OGDEN L. MILLS, TREASURER
E.B. DOUGLAS
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D.C.
MRS. FRANK v. HAMMAR
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
M
I
VATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
WILLIAM D. MITCHELL
JOHN BARTON PAYNE, CHAIRMAN
GUSTAVUS D. POPE
MRS. HENRY R. REA
JAMES L. FIESER, VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
ERNEST P. BICKNELL. VICE CHAIRMAN
JOHN D. RYAN
uri
e
GEORGE E. SCOTT
e
M
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
I
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in the enclosed envelope, at the earliest possible date.
IMPORTANT:
Yours sincerely,
In order to render prompt service
in time of disaster, enrolled Red Cross
madel machmell Chairman
Secretary.
nurses should report at once to the
Secretary of the Local Committee under
Stamford Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Name
in full Heelen Godsoe leffen
If
married, give husband's name Harry B. offen
Permanent address Stamfood ave, new cansisn Conn.
Probable address for the next year
same
Telephone No.
H25
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - J.S.Vet. Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been?
no
Indicate present physical condition
Facily will
Would you respond to an emergency call in event of epidemic, disaster, war, etc.? of possible
2
Badge No. 22964
Current date
may 30.29
2
NOTE. If the nurse does not complete and return this questionnaire, and can not be
a
located within two years, her enrollment will be annulled.
6
4
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"ocrText": "I\nO\netc.\nF\nF\ne\nS\nI\nFORM 1048--REV. 2-24-27\n3\nCENTRAL COMMITTEE\nNATIONAL OFFICERS\nJOHN BARTON PAYNE, CHAIRMAN\nHERSERT HOOVER, PRESIDENT\nMRS. AUGUST BELMONT\nROBERT w. DE FOREST. VICE PRESIDENT\nCORNELIUS N. BLISS\nTS.\nWILLI (M HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nJ. REUBEN CLARK, JR.\nWILLIAM D. MITCHELL. COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nE.B. DOUGLAS\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nM\nI\nVATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nWILLIAM D. MITCHELL\nJOHN BARTON PAYNE, CHAIRMAN\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nuri\ne\nGEORGE E. SCOTT\ne\nM\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nI\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nmadel machmell Chairman\nSecretary.\nnurses should report at once to the\nSecretary of the Local Committee under\nStamford Local Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName\nin full Heelen Godsoe leffen\nIf\nmarried, give husband's name Harry B. offen\nPermanent address Stamfood ave, new cansisn Conn.\nProbable address for the next year\nsame\nTelephone No.\nH25\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - J.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been?\nno\nIndicate present physical condition\nFacily will\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? of possible\n2\nBadge No. 22964\nCurrent date\nmay 30.29\n2\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\na\nlocated within two years, her enrollment will be annulled.\n6\n4"
}