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FORM 1045--REV. 2-24-27 NATIONAL OFFICERS CENTRAL COMMITTEE CALVIN COOLIDGE, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN RUBERT W.DE FOREST. VICE PRESIDENT MRS. AUGUST BELMONT CORNELIUS N. BLISS WILLIAM HOWARD TAFT. VICE PRESIDENT THE AMERICAN RED CROSS MABEL T. BOARDMAN WILLIAM D. MITCHELL. COUNSELOR J. .REUBEN CLARK, JR. OGDEN L. MILLS, TREASURER NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON E.B. DOUGLAS MABEL T. BOARDMAN, SECRETARY WASHINGTON, D.C. MRS. FRANK v. HAMMAR HERBERT HOOVER MAJ. GEN. M. w. IRELAND NATIONAL EXECUTIVE OFFICERS SAMUEL KNIGHT OGDEN L. MILLS JOHN BARTON PAYNE, CHAIRMAN WILLIAM D. MITCHELL JAMES L. FIESER, VICE CHAIRMAN GUSTAVUS D. POPE ERNEST P. BICKNELL, VICE CHAIRMAN MRS. HENRY R. REA REAR ADMIRAL CHARLES E. RIGGS JOHN D. RYAN GEORGE E, SCOTT man.14-24 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 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 Chairman or in time of disaster, enrolled Red Cross Miss Florence Black Secretary. nurses should report at once to the Secretary, Local Committee Secretary of the Local Committee under Red Cross Nursing ServicGLocal Committee. which they are enrolled. Do not forget 922 Floyd Avenue the address of the Secretary. Name in full Louise mathilder Pwall Richmond, Va.j If married, give husband's name Permanent address 12.no madhington st. Slaunim brignic Probable address for the next same year Telephone No. 823 of Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Lister Lucy Lee Powall - same address Underline the type of work you are now doing: - Army - Navy - U.S.P.H. Hospital - U.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 from neromo heakdom Impossible at Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? present- Badge No. 4114 Current date march 20 1929. NOTE. - - If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrollment will be annulled.

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    "ocrText": "FORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nCALVIN COOLIDGE, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nRUBERT W.DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL. COUNSELOR\nJ. .REUBEN CLARK, JR.\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nE.B. DOUGLAS\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nMAJ. GEN. M. w. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nSAMUEL KNIGHT\nOGDEN L. MILLS\nJOHN BARTON PAYNE, CHAIRMAN\nWILLIAM D. MITCHELL\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\nERNEST P. BICKNELL, VICE CHAIRMAN\nMRS. HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nGEORGE E, SCOTT\nman.14-24\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\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\nChairman or\nin time of disaster, enrolled Red Cross\nMiss Florence Black\nSecretary.\nnurses should report at once to the\nSecretary, Local Committee\nSecretary of the Local Committee under\nRed Cross Nursing ServicGLocal Committee.\nwhich they are enrolled. Do not forget\n922 Floyd Avenue\nthe address of the Secretary.\nName in full Louise mathilder Pwall\nRichmond, Va.j\nIf married, give husband's name\nPermanent address 12.no madhington st. Slaunim brignic\nProbable address for the next same\nyear\nTelephone No. 823 of\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nLister Lucy Lee Powall - same address\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.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? no\nIndicate present physical condition from neromo heakdom\nImpossible at\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? present-\nBadge No. 4114\nCurrent date march 20 1929.\nNOTE. - - If the nurse does not complete and return this questionnaire, and can not\nbe located within two years, her enrollment will be annulled."
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