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B es + Mrs. IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND CHECK THE APPROPRIATE BOX Ne e M AVAILABILITY FOR SERVICE WITH THE ARMED FORCES a Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be- M 4 Physically fit, single, and under 40. a For assignment to the Army Nurse Corps, a Red Cross nurse must be- (b Physically fit, single OR married, and under 40. If qualified for supervision, anaesthesia, operating room work, or interested in overseas assignment, the age limit is the 45th birthday. M. If eligible and not already in service, are you Immediately available Available in the near future February (specify date) 1943 M Not available for the following reasons at M (specify) If married, do you have minor dependents? No. e (specify) M. If the Army decides to accept nurses from 40 to 44 years of age (inclusive) for all assignments, would you be E Immediately available Available in the near future (specify date) (A Not available for the following reasons 5 (specify) I AVAILABILITY FOR SERVICE WITH CIVILIANS a If not already doing so, will you Yes & Teach Red Cross Home Nursing classes, if qualified? a Teach Volunteer Nurse's Aides, if qualified? Yes 5 Serve with an overseas unit caring for civilian casualties? Yes Be available for emergency Red Cross assignments? Yes PHYSICAL CONDITION Have you been rejected for military service? Yes No Why? Do you believe that you could now meet revised physical requirements for military service? Yes No State present physical condition Good of If any disabilities, please specify Red Cross Badge No. 48315 DECEMbER 27, 1942 (date this form is filled in) Name of committee heayton this (to be filled in by committee before questionnaire is sent to the nurse) YOUR VALUE AS A RED CROSS RESERVE NURSE DEPENDS ON OUR ABILITY TO LOCATE YOU. THE NATIONAL EMERGENCY EMPHASIZES THIS FACT MORE THAN EVER. THANK YOU FOR FILLING IN THIS QUESTIONNAIRE AND RETURNING IT TO US.

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Page
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