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+ FORM 1045 REV. 1-7-30 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER. PRESIDENT JOHN BARTON PAYNE. CHAIRMAN ROBERT W. DE FOREST. VICE PRESIDENT MRS. AUGUST BELMONT CALVIN COOLIDGE, VICE PRESIDENT THE AMERICAN RED CROSS CORNELIUS N. BLISS MABEL T. BOARDMAN THOMAS D. THACHER, COUNSELOR JOSEPH P. COTTON OGDEN L. MILLS. TREASURER NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON MABEL T. BOARDMAN, SECRETARY E. B. DOUGLAS WASHINGTON. D. C. MRS. FRANK V. HAMMAR MAJ. GEN. M. W. IRELAND NATIONAL EXECUTIVE OFFICERS SAMUEL KNIGHT OGDEN L. MILLS JOHN BARTON PAYNE. CHAIRMAN GUSTAVUS D. POPE JAMES L. FIESER. VICE CHAIRMAN MRS. HENRY R. REA REAR ADMIRAL CHARLES E. RIGGS ERNEST P. BICKNELL, VICE CHAIRMAN JOHN D. RYAN JAMES K. MCCLINTOCK. VICE CHAIRMAN GEORGE E. SCOTT 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 earliest possible date. IMPORTANT: Yours sincerely, In order to render prompt service Chairman or in time of disaster, enrolled Red Cross ELLA E. MONEIT,, R.: N. Secretary. nurses should report at once to the 2100 DELANCEY STREET Secretary of the Local Committee under PHILADELPHIA; PENNA. Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full If married, give husband's name Permanent address HAOO Baltimore are (CITY) Philadelphia OUNTY) Pa- (STATE) (STREET, ETC.) Probable address for the next year same (STREET, ETC.) Telephone No. Bar 256le (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) None 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 of Red Cross classes in Home Hygiene and Care instructor of the Sick? no Have you ever been? no Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Badge No. 23904 Current date February 28-1931 NOTE.--I 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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    "ocrText": "+\nFORM 1045 REV. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER. PRESIDENT\nJOHN BARTON PAYNE. CHAIRMAN\nROBERT W. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nTHOMAS D. THACHER, COUNSELOR\nJOSEPH P. COTTON\nOGDEN L. MILLS. TREASURER\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nMABEL T. BOARDMAN, SECRETARY\nE. B. DOUGLAS\nWASHINGTON. D. C.\nMRS. FRANK V. HAMMAR\nMAJ. GEN. M. W. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nSAMUEL KNIGHT\nOGDEN L. MILLS\nJOHN BARTON PAYNE. CHAIRMAN\nGUSTAVUS D. POPE\nJAMES L. FIESER. VICE CHAIRMAN\nMRS. HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL, VICE CHAIRMAN\nJOHN D. RYAN\nJAMES K. MCCLINTOCK. VICE CHAIRMAN\nGEORGE E. SCOTT\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 earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nELLA E. MONEIT,, R.: N.\nSecretary.\nnurses should report at once to the\n2100 DELANCEY STREET\nSecretary of the Local Committee under\nPHILADELPHIA; PENNA. Local Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nIf married, give husband's name\nPermanent address HAOO Baltimore are (CITY) Philadelphia OUNTY) Pa- (STATE)\n(STREET, ETC.)\nProbable address for the next year\nsame\n(STREET, ETC.)\nTelephone No.\nBar 256le\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)\nNone\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 of Red Cross classes in Home Hygiene and Care\ninstructor of the Sick? no\nHave you ever been?\nno\nIndicate present physical condition\ngood\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 23904\nCurrent date February 28-1931\nNOTE.--I the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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