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PUBLIC HEALTH NURSING AND HOME HYGIENE
FORM 1082
REV. 3-22-37
AND CARE OF THE SICK SERVICE
8-9-38
AMERICAN NATIONAL RED CROSS
Miss L. Beauchamp
420 Peach St., Erie, Pa.
E rie chapter INSTRUCTOR'S
APPLICATION
3
Please fill out this form and RETURN to Public Health Nursing and Home Hygiene and Care of
the Sick Service. Fill out each item in detail.
5
i.
1. GENERAL INFORMATION:
ok
e
Name in full hinnie Beauchamp
Red Cross Badge
No. 30-281
H.D.
Present
address 420 Peach St. Apt. 5. Erie, Pa.
(STREET)
(CITY)
(STATE)
Erie Chapter- American Red Cross
Present position
Race White
Amer
Good
1890
Date of birth
Citizenship
Health
Single, married, separated, widowed or divorced? (Underline) If applying for a position
state your preference and limitation as to locality
2. NURSING EDUCATION:
Name of School of Nursing Memphis Training School for Nurses
Date of
Location Nemphis. Tenn,
Graduation
1912.
Registration Ark- Annually
rerepistered. (YEAR)
Postgraduate work Teacher's College N.Y.
1923-24.
(INCLUDING PUBLIC HEALTH COURSES)
(TYPES OF WORK)
(DATE)
Peabody College- Nashville, Tenn.
1937-38
If not an enrolled Red Cross nurse, have application papers been submitted to the Local
Red Cross Nursing Committee?
To whom?
When?
3. OTHER EDUCATION:
Diplomas and
Name and location
Dates attending
degrees rec'd.
High school or
equivalent
Forrest City, Arkansas
1910
Diploma
Normal
Teacher's College
1923- 24. (9 Mos.
College
Summer=schools
Peabody College- Nashville
Tenn.
1937- - 38 6 mos.
Certificate in
Public Health Nursing.
Special course in
principles of teaching Above schools
Did above course include practice teaching?
Yea
AUG 151938
PLEASE ANSWER QUESTIONS ON REVERSE SIDE
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"ocrText": "PUBLIC HEALTH NURSING AND HOME HYGIENE\nFORM 1082\nREV. 3-22-37\nAND CARE OF THE SICK SERVICE\n8-9-38\nAMERICAN NATIONAL RED CROSS\nMiss L. Beauchamp\n420 Peach St., Erie, Pa.\nE rie chapter INSTRUCTOR'S\nAPPLICATION\n3\nPlease fill out this form and RETURN to Public Health Nursing and Home Hygiene and Care of\nthe Sick Service. Fill out each item in detail.\n5\ni.\n1. GENERAL INFORMATION:\nok\ne\nName in full hinnie Beauchamp\nRed Cross Badge\nNo. 30-281\nH.D.\nPresent\naddress 420 Peach St. Apt. 5. Erie, Pa.\n(STREET)\n(CITY)\n(STATE)\nErie Chapter- American Red Cross\nPresent position\nRace White\nAmer\nGood\n1890\nDate of birth\nCitizenship\nHealth\nSingle, married, separated, widowed or divorced? (Underline) If applying for a position\nstate your preference and limitation as to locality\n2. NURSING EDUCATION:\nName of School of Nursing Memphis Training School for Nurses\nDate of\nLocation Nemphis. Tenn,\nGraduation\n1912.\nRegistration Ark- Annually\nrerepistered. (YEAR)\nPostgraduate work Teacher's College N.Y.\n1923-24.\n(INCLUDING PUBLIC HEALTH COURSES)\n(TYPES OF WORK)\n(DATE)\nPeabody College- Nashville, Tenn.\n1937-38\nIf not an enrolled Red Cross nurse, have application papers been submitted to the Local\nRed Cross Nursing Committee?\nTo whom?\nWhen?\n3. OTHER EDUCATION:\nDiplomas and\nName and location\nDates attending\ndegrees rec'd.\nHigh school or\nequivalent\nForrest City, Arkansas\n1910\nDiploma\nNormal\nTeacher's College\n1923- 24. (9 Mos.\nCollege\nSummer=schools\nPeabody College- Nashville\nTenn.\n1937- - 38 6 mos.\nCertificate in\nPublic Health Nursing.\nSpecial course in\nprinciples of teaching Above schools\nDid above course include practice teaching?\nYea\nAUG 151938\nPLEASE ANSWER QUESTIONS ON REVERSE SIDE"
}