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Form 1045 Rev. Nov. 1941 Ctc AMERICAN RED CROSS JAN 21942 M NURSING SERVICE a Name in full Barer Marie Therese Tel. No. Edmontin 1 (last) (first) (middle) alter i If married, give maiden name McCabe Marie Year of birth 1881 e Marital status. Warned (single, married, widowed, divorced) Husband's name Jerwyn Osean Permanent address 9917-11680 Elmenton alberta Canada (street) (city) (county) (state) Probable address Same for the next year (street) (city) (county) (state) Give name and address of nearest relative or friend in United States: (relationship) Sester 317 West 45 St (name) (address) Are you employed in nursing at the present time? Yes No newyour PRESENT EMPLOYMENT (check below) Name of agency or institution with which employed Institutional Public health At home helping with Industrial Womens (Canadian" Cemerations Private duty would 92 Camelesy and Cun Frome chapters - Other (write in) Government Service: Army, Regular Navy, Regular Veterans Administration Reserve Reserve Children's Bureau U.S.P.H. Service U.S. Indian Service MAJOR RESPONSIBILITIES Administration Teaching Private duty of present employment Supervision General Staff Other (specify) How many years did you attend HIGH SCHOOL? One Two Three Four Graduated Yes No SINCE GRADUATION FROM YOUR SCHOOL OF NURSING have you ever had- 1. A postgraduate course or experience in any of the following special services? Postgraduate course Experience in hospital in a hospital or public health field (at least 3 months) (at least 6 months) Communicable disease nursing (include Tbc) Psychiatric Nursing Operating room Anaesthesia Public health nursing 2. Have you taken any courses in a college or university? Less than One Two Three Four Bachelor's Master's P.H.D. Certificate in 'one year year years years years degree degree degree Public Health 5 In what major field was above study? What languages, other than English, do you speak? CENT 4 33 * Academic year (OVER)

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    "ocrText": "Form 1045\nRev. Nov. 1941\nCtc\nAMERICAN RED CROSS\nJAN 21942\nM\nNURSING SERVICE\na\nName\nin full Barer Marie Therese Tel. No. Edmontin\n1\n(last)\n(first)\n(middle)\nalter\ni\nIf married, give maiden name\nMcCabe Marie\nYear of birth 1881\ne\nMarital status. Warned\n(single, married, widowed, divorced)\nHusband's name Jerwyn Osean\nPermanent address\n9917-11680 Elmenton alberta Canada\n(street)\n(city)\n(county)\n(state)\nProbable address\nSame\nfor the next year\n(street)\n(city)\n(county)\n(state)\nGive name and address of nearest relative or friend in United States:\n(relationship) Sester\n317 West 45 St\n(name)\n(address)\nAre you employed in nursing at the present time? Yes\nNo\nnewyour\nPRESENT EMPLOYMENT (check below) Name of agency or institution with which employed\nInstitutional\nPublic health\nAt home helping with\nIndustrial\nWomens (Canadian\" Cemerations\nPrivate duty\nwould\n92 Camelesy and Cun\nFrome chapters\n-\nOther (write in)\nGovernment Service:\nArmy, Regular\nNavy, Regular\nVeterans Administration\nReserve\nReserve\nChildren's Bureau\nU.S.P.H. Service\nU.S. Indian Service\nMAJOR RESPONSIBILITIES\nAdministration\nTeaching\nPrivate duty\nof present employment\nSupervision\nGeneral Staff\nOther (specify)\nHow many years did you attend HIGH SCHOOL? One\nTwo\nThree\nFour\nGraduated\nYes\nNo\nSINCE GRADUATION FROM YOUR SCHOOL OF NURSING\nhave you ever had-\n1. A postgraduate course or experience in any of the following special services?\nPostgraduate course\nExperience in hospital\nin a hospital\nor public health field\n(at least 3 months)\n(at least 6 months)\nCommunicable disease nursing (include Tbc)\nPsychiatric Nursing\nOperating room\nAnaesthesia\nPublic health nursing\n2. Have you taken any courses in a college or university?\nLess than\nOne\nTwo\nThree\nFour\nBachelor's\nMaster's\nP.H.D.\nCertificate in\n'one year\nyear\nyears\nyears\nyears\ndegree\ndegree\ndegree\nPublic Health\n5\nIn what major field was above study?\nWhat languages, other than English, do you speak?\nCENT\n4\n33\n* Academic year\n(OVER)"
}