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FORM 1045
REV. OCT. 1943
AMERICAN RED CROSS
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
Red Cross
If you have changed your last name
Badge number
since contacting us, please check here.
Name in full San (last) diford (first) annie
Rita
Tel. No. Wat.6182
(middle)
If married, give maiden name amice R. me lessely
Date of birth June 1881
Marital status
married
Husband's name Univer m. Sandiford
(single, married, widowed, divorced)
Permanent
address
Winsor
ave.
watertown
widdless
manachusete
(street)
(city)
(county)
(state)
Present address 148 Winsor ave. waterlown
middlenex
(street)
(city)
(county)
(state)
Notify national headquarters immediately if you change your address.
Give name and address of nearest relative or friend in the United States:
Univer yu handiford
148 Missor ave., Watertown (husband)
(name)
(address)
(relationship)
Are you employed in nursing at the present time? Yes
No
If employed, check the type of work you are doing and fill in below the title of your position and the name
and address of the agency or institution:
Institutional
Public Health
Industrial
Private Duty
Other
locid marker - Department Public melfare Commonwealet
of
If not employed, what type of nursing would you prefer to render?
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you
Immediately available?
Available in the near future?
(specify date)
Not
available,
for
the
following
reason?
full
trice
employeement
(specify)
Do
you
have
any
dependents
14
years
of
age?
Yes
No
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
Of
To teach Red Cross Home Nursing classes?
To teach volunteer nurse's aides?
To take a Red Cross emergency assignment?
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If yes, specify type of disaster
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- e98c3f43da21b8f1
- Size
- unknown
Document data
- ID
- 2662214
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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"ocrText": "vani\nFORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nIf you have changed your last name\nBadge number\nsince contacting us, please check here.\nName in full San (last) diford (first) annie\nRita\nTel. No. Wat.6182\n(middle)\nIf married, give maiden name amice R. me lessely\nDate of birth June 1881\nMarital status\nmarried\nHusband's name Univer m. Sandiford\n(single, married, widowed, divorced)\nPermanent\naddress\nWinsor\nave.\nwatertown\nwiddless\nmanachusete\n(street)\n(city)\n(county)\n(state)\nPresent address 148 Winsor ave. waterlown\nmiddlenex\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nUniver yu handiford\n148 Missor ave., Watertown (husband)\n(name)\n(address)\n(relationship)\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nlocid marker - Department Public melfare Commonwealet\nof\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot\navailable,\nfor\nthe\nfollowing\nreason?\nfull\ntrice\nemployeement\n(specify)\nDo\nyou\nhave\nany\ndependents\n14\nyears\nof\nage?\nYes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nOf\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster"
}