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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."
}