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Form 1045-Rev. 2-16-21
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
MRS. AUGUST BELMONT
CALVIN COOLIDGE, VICE PRESIDENT
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
CHARLES EVANS HUGHES. VICE PRESIDENT
MABEL T. BOARDMAN
THOMAS D. THACHER, COUNSELOR
WILLIAM R. CASTLE, JR.
NATIONAL HEADQUARTERS
MRS. HENRY P. DAVISON
OGDEN L. MILLS. TREASURER
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D. C.
SAMUEL KNIGHT
OGDEN L. MILLS
MAJ. GEN. ROBERT U. PATTERSON
NATIONAL EXECUTIVE OFFICERS
GUSTAVUS D. POPE
MRS. HENRY R. REA
JOHN BARTON PAYNE. CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
JAMES L. FIESER, VICE CHAIRMAN
JOHN D. RYAN
ERNEST P. BICKNELL, VICE CHAIRMAN
GEORGE E. SCOTT
HENRY UPSON SIMS
JAMES K. McCLINTOCK, VICE CHAIRMAN
THOMAS D. THACHER
ELIOT WADSWORTH
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 enclosed envelope, at the eariest possible date.
IMPORTANT:
Yours sincerely,
In order to render prompt service
in time of disaster, enrolled Red Cross
GATHERINE BUCKLEY
Chairman or
Secretary Local Committee A. R. €.
Secretary
Nurses should report at once to the
Secretary of the Local Committee under
GENERAL HOSPITAL
CINCINNATI, OHIO
Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Name in full Margut
If married, give husband's name George a. Schedder
Permanent address
1734 Beacon Center Hamulton
Ohio
(STREET, ETC.)
(CITY)
(COUNTY)
(STATE)
Probable address for the next year
Same
(STREET, ETC.)
Telephone No. Sutton 222 R
(CITY)
(COUNTY)
(STATE)
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Husband
Underline the type of work you are now doing:
Army - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service -
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
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Badge No. 20393
Current date march 29-1932
NOTE.- -If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "Form 1045-Rev. 2-16-21\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nCHARLES EVANS HUGHES. VICE PRESIDENT\nMABEL T. BOARDMAN\nTHOMAS D. THACHER, COUNSELOR\nWILLIAM R. CASTLE, JR.\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS. TREASURER\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D. C.\nSAMUEL KNIGHT\nOGDEN L. MILLS\nMAJ. GEN. ROBERT U. PATTERSON\nNATIONAL EXECUTIVE OFFICERS\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nJOHN BARTON PAYNE. CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJAMES L. FIESER, VICE CHAIRMAN\nJOHN D. RYAN\nERNEST P. BICKNELL, VICE CHAIRMAN\nGEORGE E. SCOTT\nHENRY UPSON SIMS\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nTHOMAS D. THACHER\nELIOT WADSWORTH\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 enclosed envelope, at the eariest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nGATHERINE BUCKLEY\nChairman or\nSecretary Local Committee A. R. €.\nSecretary\nNurses should report at once to the\nSecretary of the Local Committee under\nGENERAL HOSPITAL\nCINCINNATI, OHIO\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Margut\nIf married, give husband's name George a. Schedder\nPermanent address\n1734 Beacon Center Hamulton\nOhio\n(STREET, ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nSame\n(STREET, ETC.)\nTelephone No. Sutton 222 R\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nHusband\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service -\nPublic Health - 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\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 20393\nCurrent date march 29-1932\nNOTE.- -If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}