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a no number NUMBER assigned m RED CROSS BADGE NURSING SERVICES MILITARY SERIAL Home NUMBER Defense - AMERICAN RED CROSS - ANNUAL QUESTIONNAIRE - 1945 CHECK IF YOUR LAST NAME HAS CHANGED TELEPHONE NO. NAME (Last, first, middle) Buell Ellen Louise Potomac 0122 HUSBAND'S NAME IF MARRIED, GIVE MAIDEN NAME o PERMANENT (Street, city, zone, county, state) ADDRESS 1875 Fourt Hills Blrd Cireland PRESENT ADDRESS (Street, city, zone, county, state) same RELATIONSHIP NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES H.D. Buell (Month, day, year) 524 Ostrom Single are Married Supersse Separated by brother DATE OF BIRTH Widowed Divorced may 11 1889 YES NO WHAT LANGUAGES DO YOU SPEAK? HIGH SCHOOL GRADUATE Eugl: sly X DEGREE OR NAME OF COLLEGE OR UNIVERSITY ATTENDED INCLUSIVE DATES DIPLOMA MAJOR LOCATION Simmune College Buston 1917-18 Diplana P.H.N. Teachers College Columbia newyorklist B.S. - 1928 Pltn. ARE YOU CURRENTLY A MEMBER OF THE AMERICAN YES NO ARE YOU CURRENTLY YES NO REGISTERED IN (State) REGISTERED? X n.y. g Chio NURSES' ASSOCIATION? X PRESENT EMPLOYMENT If not employed, check SERVICE (Medicine, surgery, etc.) POSITION TITLE (H.N., P.D., inst., staff nurse, etc.) Dir. Programs in PHn. Wederm Res. EMPLOYED Unir P.H. CITY nursing STATE NAME School nursing Western Res, AND Unir. ANTICIPATED OF HOSPITAL OR ORGANIZATION BY WHOM Cleveland HEALTH IF OTHER THAN GOOD, SPECIFY NATURE DURATION OF DISABILITY The purpose of the following statements is to identify the nurses who can be counted upon to respond to able a call to good VOLUNTEER SERVICE to participate in a Red Cross chapter program. Please check the "Yes" box only if you are willing and NAME AND ADDRESS OF THE CHAPTER IN WHQSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS serve if called on within the next 12 months. cleseland Attend an instructors' training program, 1f offered. (Funds are available for YES NO 1. Teach home YES NO nursing classes training home nursing instructors. See local chapter.) X Attend disaster institutes, if YES NO 2. Serve in case YES NO only in home community of disaster R In other communities offered, in preparation for service 4. Accept membership on chapter cóm- YES NO 5. Assist with other chapter YES NO 3. Teach nurse's YES NO mittee should services be needed programs, as needed X aide classes If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES NO t you will be able to serve at some time in the future? IF UNABLE TO SERVE, GIVE MAJOR REASONS. DATE full time SI poition GNATURE which parents YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND. YOUR FAITHPELNESS TO THE IN August 12-1945 Ellen LBuell KEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY COMMITTEE NAMED BELOW. ATTENTION Fill in committee name and address before sending questionnaire to nurse. SECRETARY NURSE RECRUITMENT Greater Cleveland Chapter HAD I AMERICAN RED CROSS COMMITTEE NURSE RECRUITMENT COMMITTEE FORM 1045 Rev. July 1945 78504M 1227 Prospect Ave., Cleveland 15, Ohio

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    "ocrText": "a\nno number NUMBER assigned\nm\nRED CROSS BADGE\nNURSING SERVICES\nMILITARY SERIAL\nHome NUMBER Defense\n-\nAMERICAN RED CROSS\n-\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nTELEPHONE NO.\nNAME (Last, first, middle)\nBuell Ellen Louise\nPotomac 0122\nHUSBAND'S NAME\nIF MARRIED, GIVE MAIDEN NAME\no\nPERMANENT (Street, city, zone, county, state)\nADDRESS 1875 Fourt Hills Blrd Cireland\nPRESENT ADDRESS (Street, city, zone, county, state)\nsame\nRELATIONSHIP\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nH.D.\nBuell (Month, day, year) 524 Ostrom Single are Married Supersse Separated by\nbrother\nDATE OF BIRTH\nWidowed\nDivorced\nmay 11 1889\nYES\nNO\nWHAT LANGUAGES DO YOU SPEAK?\nHIGH SCHOOL GRADUATE\nEugl: sly\nX\nDEGREE OR\nNAME OF COLLEGE OR\nUNIVERSITY ATTENDED\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nLOCATION\nSimmune College Buston\n1917-18\nDiplana\nP.H.N.\nTeachers College Columbia newyorklist\nB.S. - 1928 Pltn.\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nREGISTERED?\nX\nn.y. g Chio\nNURSES' ASSOCIATION?\nX\nPRESENT EMPLOYMENT If not employed, check\nSERVICE (Medicine, surgery, etc.)\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.)\nDir. Programs in PHn. Wederm Res. EMPLOYED Unir\nP.H. CITY nursing\nSTATE\nNAME School nursing Western Res, AND Unir. ANTICIPATED\nOF HOSPITAL OR ORGANIZATION BY WHOM\nCleveland\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE DURATION OF DISABILITY\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to able a call to\ngood\nVOLUNTEER SERVICE\nto\nparticipate in a Red Cross chapter program. Please check the \"Yes\" box only if you are willing and\nNAME AND ADDRESS OF THE CHAPTER IN WHQSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\nserve if called on within the next 12 months.\ncleseland\nAttend an instructors' training program, 1f offered. (Funds are available for\nYES\nNO\n1. Teach home\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\nX\nAttend disaster institutes, if\nYES\nNO\n2. Serve in case\nYES\nNO\nonly in home community\nof disaster\nR\nIn other communities\noffered, in preparation for service\n4. Accept membership on chapter cóm-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\n3.\nTeach nurse's\nYES\nNO\nmittee should services be needed\nprograms, as needed\nX\naide classes\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that\nYES\nNO\nt\nyou will be able to serve at some time in the future?\nIF UNABLE TO SERVE, GIVE MAJOR REASONS.\nDATE\nfull time SI poition GNATURE which parents\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND. YOUR FAITHPELNESS TO THE IN\nAugust 12-1945\nEllen LBuell\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY\nCOMMITTEE NAMED BELOW.\nATTENTION\nFill in committee name and address before sending questionnaire to nurse.\nSECRETARY\nNURSE RECRUITMENT\nGreater Cleveland Chapter\nHAD\nI\nAMERICAN RED CROSS\nCOMMITTEE\nNURSE RECRUITMENT COMMITTEE\nFORM 1045 Rev. July 1945\n78504M\n1227 Prospect Ave.,\nCleveland 15, Ohio"
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