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Revised May 20, 1918.
Top Sheet
Upper portion for Bivisional Record. Also see last portion of application
form.
Recommended by Atlantic Division for enrollment under Requisition luroing
If not American citizen, so state, and give citizenship
Is applicant available leaving home two weeks from date full papers are rec'd in
Washington yes
Name luro luary lualtly wondward Street Address 162 Punisale Rd.
City Rochester h.y.
Temporary Address to what date
3
Please check or fill out blanks where possible.
Languages spoken
Location of
E-Excellent
Service desired
Full Volunteer
Proposed length of stay 1year 00 more
no
G-Good F-Fair
Volunteer with expenses met by Red Cross yes
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? $70
Allowance for living prior to day
salary over expense allowance if any
Requisition for uniform and equipment
Allowance for transportation overseas and re-
turn
he
Allowance for transportation in U.S.and return
yes
Physical Report
Age 39
Loyalty investigation conducted by (Name of agency
Date examined
Date Reported
employed, if any)
and Report
leational Conurer cial ageray
List of Loyalty indorsements:
lurs thank E Wardworth
lur C.C. werver
miss ona warner
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
Provisional Enrollment
War Dept. 9/11
Physical
Actual Enrollment
Remarks
23,
w
Page data
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- Source index
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- Type
- photo
- Media ID
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- Size
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Document data
- ID
- 2662514
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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Document source metadata
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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 Bivisional Record. Also see last portion of application\nform.\nRecommended by Atlantic Division for enrollment under Requisition luroing\nIf not American citizen, so state, and give citizenship\nIs applicant available leaving home two weeks from date full papers are rec'd in\nWashington yes\nName luro luary lualtly wondward Street Address 162 Punisale Rd.\nCity Rochester h.y.\nTemporary Address to what date\n3\nPlease check or fill out blanks where possible.\nLanguages spoken\nLocation of\nE-Excellent\nService desired\nFull Volunteer\nProposed length of stay 1year 00 more\nno\nG-Good F-Fair\nVolunteer with expenses met by Red Cross yes\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? $70\nAllowance for living prior to day\nsalary over expense allowance if any\nRequisition for uniform and equipment\nAllowance for transportation overseas and re-\nturn\nhe\nAllowance for transportation in U.S.and return\nyes\nPhysical Report\nAge 39\nLoyalty investigation conducted by (Name of agency\nDate examined\nDate Reported\nemployed, if any)\nand Report\nleational Conurer cial ageray\nList of Loyalty indorsements:\nlurs thank E Wardworth\nlur C.C. werver\nmiss ona warner\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\nProvisional Enrollment\nWar Dept. 9/11\nPhysical\nActual Enrollment\nRemarks\n23,\nw"
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