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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."
}