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FORM 1045
REV. 4-4-38
THE AMERICAN RED CROSS
NATIONAL HEADQUARTERS
WASHINGTON. D. C.
Dear Red Cross Nurse:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a report of all the Red Cross Nurses enrolled with our Committee. Will you
therefore, please answer the following questions and return this form to me, in the
enclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED
WITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-
ognize the value of filing this information and will return the questionnaire promptly,
as we are extremely anxious to make a very complete report to National Headquarters.
IMPORTANT:
In order to render prompt service
Yours sincerely,
in time of disaster, enrolled Red Cross
Chairman or
LUCY A. BARKER
Nurses should report at once to the
Serving State and Local Committee,
Secretary.
Secretary of the Local Committee under
Red Cross Nursing Service,
Local Committee.
which they are enrolled. Do not forget
"BELFAST, MAINE
the address of the Secretary.
Name in full Daura Knowlton Turner
If married, give husband's name myron S. Turner
Permanent address
Vassalboro Kennebee maine
(STREET, ETC.)
(CITY)
(COUNTY)
(STATE)
Probable address for the next year
waterville
(STREET. ETC.)
Telephone No. 598-
Vassalboro
Kenneber
maine
(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)
Underline the type of work you are now doing:
myron S. Turner
husband
Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service
-
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 Would you like to teach Red Cross classes? yes
Indicate present physical condition good
Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes,
duties
iftic
Badge No. 36718
Current date Jan. 29, 1939 family allow
NOTE. If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be removed from our active files.
Page data
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Document data
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- Core
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- Type
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"ocrText": "FORM 1045\nREV. 4-4-38\nTHE AMERICAN RED CROSS\nNATIONAL HEADQUARTERS\nWASHINGTON. D. C.\nDear Red Cross Nurse:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a report of all the Red Cross Nurses enrolled with our Committee. Will you\ntherefore, please answer the following questions and return this form to me, in the\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\nWITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-\nognize the value of filing this information and will return the questionnaire promptly,\nas we are extremely anxious to make a very complete report to National Headquarters.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman or\nLUCY A. BARKER\nNurses should report at once to the\nServing State and Local Committee,\nSecretary.\nSecretary of the Local Committee under\nRed Cross Nursing Service,\nLocal Committee.\nwhich they are enrolled. Do not forget\n\"BELFAST, MAINE\nthe address of the Secretary.\nName in full Daura Knowlton Turner\nIf married, give husband's name myron S. Turner\nPermanent address\nVassalboro Kennebee maine\n(STREET, ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nwaterville\n(STREET. ETC.)\nTelephone No. 598-\nVassalboro\nKenneber\nmaine\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)\nUnderline the type of work you are now doing:\nmyron S. Turner\nhusband\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service\n-\nPublic Health - 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 Would you like to teach Red Cross classes? yes\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? yes,\nduties\niftic\nBadge No. 36718\nCurrent date Jan. 29, 1939 family allow\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be removed from our active files."
}