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OCR Page 1 of 168:
D.M.R.-I
AMERICAN RED CROSS
(CROIX-ROUGE AMÉRICAINE)
which
LD
ÉLYSÉES 43-82
ADRESSE TÉLÉGRAPHIQUE :
"
43-83
TÉLÉPHONE
"
43-88
"
'43-89
d/ this Same AMCROSS on Hay
3
3
4, PLACE DE LA CONCORDE
NURSING SERVICE
PARIS, Frause
at
in
e.
TOBE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting and each question answered fully)
paret
3
1. Name of applicant in full margaret O' Joole
2. Address in full, Street. Summait
City Clinton
3. Date of birth Oct 251895
suith
Place of birth Louis burg - Ireland
4. Are you married, single or a widow P
Are you a citizen of the United States ?
no
5. Have you any physical defects or tendency to constitutional or pulmonary trouble ?
no
Are you physically strong and healthy ?
Fro
6. Name educational institutions attended before entering training school, stating number of years at each and from which you were graduated
Clinton High School
7. What languages other than English do you speak P
Frinnch
8. Occupation before entering training school
none
px
ok
9. From what hospital training school did you receive your diploma ? Boston City Hospital
City state
and Boston mass achusetts
Date of graduation June 16th 1910
10. Character of hospital : General ?
yes
Special ?
Private ?
11. Did your training include obstetrics ? foo Care of men ? yes Children ? yes Contagious diseases ? yes
12. Daily average number of patients in hospitals during training Between 78800 Length of course Three years
13.
Boston- city Hospital Brston-massachuoetts
Name and address of superintendent of training school under whom you received training miss Lucy-Brown
14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each
-
15. Of what nursing organizations are you a member ?
16. Which, if any, is affiliated with the American Nurses Association ?
17. Give name and address of secretary of at least one of these organizations
18. Are you a registered nurse ? no
In what state ?
Date of registration
19. State how, where and for what period of time, in each instance, you have been employed since graduation, including present employment,
I han giving name bren and address rmp of persons loyed in charge from Private april morong 1915 to Oct. in new 2/- tyrat fork for military 3 years Hospit
Ris-orangis- Tmonths Johnstone- Reckitt) ambulance. americane
namilly Paris-Staff nurse (miss Willingale nevilly Paris) Hisital military
girlly- setm. C2 years. (Miss Bickelle Suitly etm.)
(Specify for which of the following services you wish to be considered.)
20. War service, wherever needed Juilly or Paris U. S.
only
When available
-
Are you willing to take the oath of allegiance P
780
21.
Instructor, Elementary Hygiene mino-Bettingill Home Dietetics min Catou Surgical Dressings
22. Public Health Nursing in Town and Country Nursing Service
Jes
3
23. Name and permanent address of nearest relative Mr L. Toole - adams Shore Suney mass
0
W
Date. July 16-1918
Signature
margard O'Joole
To the Committée :
This blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, and A. R. C. 150. Appli-
cation forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorsement by Local
Committee, with credentials (Forms 3 and 4) together with Forms 10 and 11, should be forwarded to the Chairman, National Committee on
Nursing Service, American Red Cross, Washington, D. C.
In case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local Committee,
instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Committee, from whence credentials
will be procured.
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