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FORM 1045--REV. 2-24-27 NATIONAL OFFICERS CENTRAL COMMITTEE JOHN BARTON PAYNE, CHAIRMAN CALVIN COOLIDGE. PRESIDENT MRS, AUGUST BELMONT ROBERT w. DE FOREST, VICE PRESIDENT CORNELIUS N. BLISS WILLIAM HOWARD TAFT. VICE PRESIDENT THE AMERICAN RED CROSS MABEL T. BOARDMAN MRS, HENRY P. DAVISON WILLIAM D. MITCHELL, COUNSELOR NATIONAL HEADQUARTERS CHARLES s. DEWEY CHARLES s. DEWEY, TREASURER E. B. DOUGLAS MABEL T. BOARDMAN. SECRETARY WASHINGTON. D.C. JOSEPH c. GREW MRS. FRANK v. HAMMAR HERBERT HOOVER MAJ. GEN. M. W.IRELAND NATIONAL EXECUTIVE OFFICERS WILLIAM D. MITCHELL w. w. MORROW JOHN BARTON PAYNE, CHAIRMAN GUSTAVUS D. POPE JAMES L. FIESER, VICE CHAIRMAN MRS. HENRY R. REA ERNEST P. BICKNELL. VICE CHAIRMAN JOHN D. RYAN GEORGE E. SCOTT REAR ADMIRAL E. R. STITT Miss Emily H. Smith, 315 Prospect Ave., m Ingram, Penna. 1928 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: In order to render prompt service Yours sincerely, Chairman or in time of disaster, enrolled Red Cross F. ELNA SMITTEN, R. N. Secretary. nurses should report at once to the Secretary of the Local Committee under Secretary Local Committee, Local Committee. which they are enrolled. Do not forget American Rea Cross Nursing Service. the address of the Secretary. Name in full Emily Hawewoud sunch If married, give husband's name Permanent address 315 Praspect are Ingram Caftern P.6. Pa Probable address for the next year as abon Telephone No. Walnut 0246 Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Paul R. Smith Hillerest Bend. Philipabury n.J. 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? yes Indicate present physical condition food Would you respond to an emergency call in epidemic, event of disaster, war, etc. ? to Badge No. #13,377. Current date Jany 19. 1928 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\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. PRESIDENT\nMRS, AUGUST BELMONT\nROBERT w. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nMRS, HENRY P. DAVISON\nWILLIAM D. MITCHELL, COUNSELOR\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nCHARLES s. DEWEY, TREASURER\nE. B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D.C.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nMAJ. GEN. M. W.IRELAND\nNATIONAL EXECUTIVE OFFICERS\nWILLIAM D. MITCHELL\nw. w. MORROW\nJOHN BARTON PAYNE, CHAIRMAN\nGUSTAVUS D. POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nREAR ADMIRAL E. R. STITT\nMiss Emily H. Smith,\n315 Prospect Ave.,\nm\nIngram, Penna.\n1928\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:\nIn order to render prompt service\nYours sincerely,\nChairman or\nin time of disaster, enrolled Red Cross\nF. ELNA SMITTEN, R. N.\nSecretary.\nnurses should report at once to the\nSecretary of the Local Committee under\nSecretary Local Committee,\nLocal Committee.\nwhich they are enrolled. Do not forget\nAmerican Rea Cross Nursing Service.\nthe address of the Secretary.\nName in full\nEmily Hawewoud sunch\nIf married, give husband's name\nPermanent\naddress 315 Praspect are Ingram Caftern P.6. Pa\nProbable address for the next year\nas abon\nTelephone No. Walnut 0246\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nPaul R. Smith Hillerest Bend. Philipabury n.J.\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? yes\nIndicate present physical condition food\nWould you respond to an emergency call in epidemic,\nevent of disaster, war, etc. ? to\nBadge No. #13,377.\nCurrent date Jany 19. 1928\nNOTE. --If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
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