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A.R.C. MAIL ROOM
RECEIVED
10 DESTROYED
QUESTIONNAIRES
evil
APR FORM 104340
REVIDEO 1939
AMERICAN RED CROSS
Referred to
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
APR 18 1940
Name in full
Schladweiler.
Rosa
Marie
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Permanent address Box III
Madison
Lac Qui Parle
Minnesota
(STREET)
(CITY)
(COUNTY)
(STATE)
Probable address
for the next year I709 Washington Ave; St. Louis
St. Louis
Missouri
(STREET)
(CITY)
(COUNTY)
(STATE)
Telephone
number - Can't recall this number
(EXCHANGE)
(NO.)
Nearest relative or friend in United States, through whom you may be communicated with in
an emergency:
Miss Margaret Schladweiler:
Sister
(NAME)
(RELATIONSHIP)
Box II7
Madison
Minnesota
(STREET)
(CITY)
(STATE)
PRESENT WORK (check below)
Name of agency or institution with which employed
Institutional
Public Health
X
Nursing Consultant, American National Red Cross
Midwestern Branch
Private duty
Other (write in)
Government Service: Army
U.S. .P.H.Service
Veterans Administration
Navy
U.S. Indian Service
Children's Bureau
IF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other (write in)
Would you respond to an emergency call in event of local or national emergency, such as
epidemic, flood, war, etc.
Yes
(Granted of course that you could be released from present employment)
Present physical condition Excellent
Would you be interested in teaching classes in Home Hygiene and Care of the Sick?
Are you a member of the American Nurses' Association?
Yes
If not, why have you allowed your membership to lapse?
Badge No. 49,263
Current date April 22, I940
NATIONAL HEADQUARTERS
Name of Committee
Note: If a nurse does not complete and return this questionnaire, and cannot be located
within two years, her enroilment Will be removed from our active files.
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- Source index
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- Type
- photo
- Media ID
- 09a87e70671f8be7
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Document data
- ID
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- Core
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- Type
- document
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Context sent to Scholar
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"ocrText": "A.R.C. MAIL ROOM\nRECEIVED\n10 DESTROYED\nQUESTIONNAIRES\nevil\nAPR FORM 104340\nREVIDEO 1939\nAMERICAN RED CROSS\nReferred to\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\nAPR 18 1940\nName in full\nSchladweiler.\nRosa\nMarie\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address Box III\nMadison\nLac Qui Parle\nMinnesota\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address\nfor the next year I709 Washington Ave; St. Louis\nSt. Louis\nMissouri\n(STREET)\n(CITY)\n(COUNTY)\n(STATE)\nTelephone\nnumber - Can't recall this number\n(EXCHANGE)\n(NO.)\nNearest relative or friend in United States, through whom you may be communicated with in\nan emergency:\nMiss Margaret Schladweiler:\nSister\n(NAME)\n(RELATIONSHIP)\nBox II7\nMadison\nMinnesota\n(STREET)\n(CITY)\n(STATE)\nPRESENT WORK (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nX\nNursing Consultant, American National Red Cross\nMidwestern Branch\nPrivate duty\nOther (write in)\nGovernment Service: Army\nU.S. .P.H.Service\nVeterans Administration\nNavy\nU.S. Indian Service\nChildren's Bureau\nIF NOT ACTIVE IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther (write in)\nWould you respond to an emergency call in event of local or national emergency, such as\nepidemic, flood, war, etc.\nYes\n(Granted of course that you could be released from present employment)\nPresent physical condition Excellent\nWould you be interested in teaching classes in Home Hygiene and Care of the Sick?\nAre you a member of the American Nurses' Association?\nYes\nIf not, why have you allowed your membership to lapse?\nBadge No. 49,263\nCurrent date April 22, I940\nNATIONAL HEADQUARTERS\nName of Committee\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enroilment Will be removed from our active files."
}