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Revised May 20, 1918.
Top Sheet
Upper portion for Eivisional Record. Also see last portion of application
form.
Recommended by Lake Division for enrollment under Requisition Nurs ing
If not American citizen, so state, and give citizenship Canadian
Is applicant available leaving home two weeks from date full papers are rec'd in
Washington
Name Stinson, Theresa Jane
Street Address 6802 Carnagie Ave.,
City
Cleveland, Ohio
Temporary Address to what date
Please check or fill out blanks where possible.
Languages spoken
(Location of
Proposed length of stay 1 yr or more
E-Excellent
Service desired
Full Volunteer
G-Good F-Fair
Volunteer with expenses met by Red Cross
Is allowance for living abroad to be left to
discretion of foreign Commission?
Allowance for living abroad if not left to
discretion of foreign Commission?
salary over expense allowance if any 70.00
Allowance for living prior to departure
Requisition for uniform and equipment
Allowance for transportation overseas and re-
turn
Allowance for transportation in U.S.and return
Physical Report
Age 35
Loyalty investigation conducted by (Name of agency
Date examined
Date Reported
employed, if any)
Oct. 4, 1918
and Report
Katherine Fairlamb
List of Loyalty indorsements:
Dr. W. c. Wychoff
Elizabeth Heler,
Dr. B. c. Maxwell
Have passport application and pictures been forwarded
Date
Headquarters Record (Initial, date, and "o.K." where acceptable)
File Record
Date
Referred to
Classification
Full papers
MN-1 France
Provisional Enrollment
10-28-18 Sc
War Dept. 11/5/18
Physical
Actual Enrollment
the
Remarks
,
Page data
- Page
- 82
- Source index
- 0
- Type
- photo
- Media ID
- a04b88fb8a57a77d
- Size
- unknown
Document data
- ID
- 2662316
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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Page context
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"ocrText": "Revised May 20, 1918.\nTop Sheet\nUpper portion for Eivisional Record. Also see last portion of application\nform.\nRecommended by Lake Division for enrollment under Requisition Nurs ing\nIf not American citizen, so state, and give citizenship Canadian\nIs applicant available leaving home two weeks from date full papers are rec'd in\nWashington\nName Stinson, Theresa Jane\nStreet Address 6802 Carnagie Ave.,\nCity\nCleveland, Ohio\nTemporary Address to what date\nPlease check or fill out blanks where possible.\nLanguages spoken\n(Location of\nProposed length of stay 1 yr or more\nE-Excellent\nService desired\nFull Volunteer\nG-Good F-Fair\nVolunteer with expenses met by Red Cross\nIs allowance for living abroad to be left to\ndiscretion of foreign Commission?\nAllowance for living abroad if not left to\ndiscretion of foreign Commission?\nsalary over expense allowance if any 70.00\nAllowance for living prior to departure\nRequisition for uniform and equipment\nAllowance for transportation overseas and re-\nturn\nAllowance for transportation in U.S.and return\nPhysical Report\nAge 35\nLoyalty investigation conducted by (Name of agency\nDate examined\nDate Reported\nemployed, if any)\nOct. 4, 1918\nand Report\nKatherine Fairlamb\nList of Loyalty indorsements:\nDr. W. c. Wychoff\nElizabeth Heler,\nDr. B. c. Maxwell\nHave passport application and pictures been forwarded\nDate\nHeadquarters Record (Initial, date, and \"o.K.\" where acceptable)\nFile Record\nDate\nReferred to\nClassification\nFull papers\nMN-1 France\nProvisional Enrollment\n10-28-18 Sc\nWar Dept. 11/5/18\nPhysical\nActual Enrollment\nthe\nRemarks\n,"
}