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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 identity
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Page context
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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."
}