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Woodward, Mrs. Mary Malthy

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AUG 1 4 RECD RED CROSS BADGE NUMBER AMERICAN RED CROSS 23366 NURSING SERVICES MILITARY SERIAL NUMBER ANNUAL QUESTIONNAIRE - 1945 CHECK IF YOUR LAST NAME HAS CHANGED NAME (Last, first, middle) TELEPHONE NO. H Woo dward Me zuz M. ltby IF MARRIED, GIVE MAIDEN NAME HUSBAND'S NAME PERMANENT ADDRESS (Street, city, zone, county, state) Castle Point N.Y. Duchess, Co. PRESENT ADDRESS (Street, city, zone, county, state) Castle Point N.Y. Duchess Co. NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES RELATIONSHIP Harry Jame's Maltby Mobridge So. Dokots Brother DATE OF BIRTH (Month, day, year) . Fobruery 21st 1.883 19 Single Married Separated Widowed vorced WHAT LANGUAGES DO YOU SPEAK? YES NO HIGH SCHOOL GRADUATE NAME OF COLLEGE OR UNIVERSITY ATTENDED LOCATION INCLUSIVE DATES DIPLOMA MAJOR Rochester University -Public Haalth Course 1921-22 Yes ARE YOU CURRENTLY YES REGISTERED IN (State) ARE YOU CURRENTLY A MEMBER OF THE AMERICAN YES NO REGISTERED? NURSES' ASSOCIATION? PRESENT EMPLOYMENT If not employed, check POSITION TITLE (H.N., P.D., inst., staff nurse, etc.) SERVICE (Medicine, surgery, etc.) staff Nurse NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED CITY STATE Veterang! Hospital Castle Point N.Y. HEALTH Good IF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY VOLUNTEER SERVICE The purpose of the following statements is to identify the nurses who can be counted upon to respond to a call to participate in a Red Cross chapter program. Please check the "Yes" box only if you are wi illing and able to serve if called on within the next 12 months. NAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS 1. Teach home YES NO Attend an instructors' training program, 1f offered. (Funds are available for YES NO nursing classes training home nursing instructors. See local chapter.) 2. Serve in case YES NO only in home community Attend disaster institutes, if YES NO of disaster In other communities offered, in preparation for service 3. Teach nurse's YES NO 4. Accept membership on chapter cóm- YES NO 5. Assist with other chapter YES NO aide classes mittee should services be needed programs, as needed If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES NO you will be able to serve at some time in the future? IF UNABLE TO SERVE, GIVE MAJOR REASONS DATE august 12.1943 YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS 10 SERVE AND YOUR PAITHPULNESS SIGNATURE mary in. Wooduard IN KEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY TO THE COMMITTEE NAMED BELOW. NURSE RECRUITMENT COMMITTEE ATTENTION Fill in committee name and address before sending questionnaire to nutMerican RED GROSS SECRETARY 47 CANNON STREET C NURSE RECRUITMENT COMMITTEE POUGHKEEPSIE, N. Y, 78504M FORM 1045 Rev. July 1945 23 ,

Page data

Page
8
Source index
0
Type
photo
Media ID
64bd777626cdea90
Size
unknown

Document data

ID
2662514
Core
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Type
document
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Context sent to Scholar

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    "ocrText": "AUG 1 4 RECD\nRED CROSS BADGE NUMBER\nAMERICAN RED CROSS\n23366\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nNAME (Last, first, middle)\nTELEPHONE NO.\nH\nWoo dward Me zuz M. ltby\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nPERMANENT ADDRESS (Street, city, zone, county, state)\nCastle Point N.Y. Duchess, Co.\nPRESENT ADDRESS (Street, city, zone, county, state)\nCastle Point N.Y. Duchess Co.\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nHarry Jame's Maltby\nMobridge So. Dokots\nBrother\nDATE OF BIRTH (Month, day, year)\n.\nFobruery 21st 1.883 19\nSingle\nMarried\nSeparated\nWidowed\nvorced\nWHAT LANGUAGES DO YOU SPEAK?\nYES\nNO\nHIGH SCHOOL GRADUATE\nNAME OF COLLEGE OR\nUNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nRochester University -Public Haalth Course\n1921-22\nYes\nARE YOU CURRENTLY\nYES\nREGISTERED IN (State)\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nNURSES' ASSOCIATION?\nPRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.)\nSERVICE (Medicine, surgery, etc.)\nstaff Nurse\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nCITY\nSTATE\nVeterang! Hospital\nCastle Point N.Y.\nHEALTH\nGood\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\nVOLUNTEER SERVICE\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to a call\nto\nparticipate in a Red Cross chapter program. Please check the \"Yes\" box only if you are wi illing and able to\nserve if called on within the next 12 months.\nNAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\n1. Teach home\nYES\nNO\nAttend an instructors' training program, 1f offered. (Funds are available for\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\n2. Serve in case\nYES\nNO\nonly in home community\nAttend disaster institutes, if\nYES\nNO\nof disaster\nIn other communities\noffered, in preparation for service\n3.\nTeach nurse's\nYES\nNO\n4. Accept membership on chapter cóm-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\naide classes\nmittee should services be needed\nprograms, as needed\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES\nNO\nyou will be able to serve at some time in the future?\nIF UNABLE TO SERVE, GIVE MAJOR REASONS\nDATE august 12.1943\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS 10 SERVE AND YOUR PAITHPULNESS\nSIGNATURE mary in. Wooduard IN\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY TO THE\nCOMMITTEE NAMED BELOW.\nNURSE RECRUITMENT COMMITTEE\nATTENTION\nFill in committee name and address before sending questionnaire to nutMerican RED GROSS\nSECRETARY\n47 CANNON STREET\nC\nNURSE RECRUITMENT\nCOMMITTEE\nPOUGHKEEPSIE, N. Y,\n78504M\nFORM 1045 Rev. July 1945\n23 ,"
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