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B us Form No. 200 DUPLICATE. Revised 2-15-18 AMERICAN RED CROSS No. SERVICE ENROLLMENT APPLICATION Date (OTHER THAN AS DOCTOR, SURGEON, OR NURSE) The questions should be answered as fully as possible, especially when an application for a passport may later be necessary. All answers must be in handwriting of applicant, I. Name in full Sara Gertrude Bush Telephone No Marlo-4080 J 2. Present Address 1283 Donald Avenue Cleveland Ohio (Number and Street) (City) (State) (a) If any changes of residence since August I, 1914, give these in full with dates. e Mayport Indiana March-1915 (b) What is your present business or profession? (Be specific.) Graduate nurse (Industrial) + (c) What previous business or professional experience have you had, stating nature, places and principal T dates thereof School teacher Jefferson. Co. Pa. 1907 1910 (d) Have you ever lived in Europe? If so, give names of European countries in which you have resided and respective dates of residence in each. (e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits. (f) Since August I, 1914, have you applied for a United States passport? If so, state whether application was granted, denied or withdrawn. 3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state militia. (a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex- amining official. For enrollment in Red Cross nursing service (b) Were you accepted, rejected, or is result of examination pending? Accepted 4. Date of birth 1888 , Nov. 13th (a) Place of birth Pa. Year Month Day (b) Full name of father. John Anderson Bush (c) Birthplace of father Indiana Co. Pa (d) Nationality of father American (e) If father foreign born, whether naturalized and when (f) Full maiden name of mother Ella Parantha Mohney (g) Birthplace of mother Jefferson. Co. Pa. (h) Nationality of mother American (i) If mother foreign born, whether naturalized and when (j) Full name and nationality of paternal grandfather Phillip Bush American (k) Full maiden name and nationality of paternal grandmother. Catherine Siomger Ameriom (1) Full name and nationality of maternal grand father John Mohney American (m) Full maiden name and nationality of maternal grandmother. Mary Ellen Mank Amer.. 2 (n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State nature and places of employment of each of such relatives not now in such war service. 6 (o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States, specifying which ally in every case.

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Context sent to Scholar

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Page context
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    "ocrText": "B\nus\nForm No. 200\nDUPLICATE.\nRevised 2-15-18\nAMERICAN RED CROSS\nNo.\nSERVICE ENROLLMENT APPLICATION\nDate\n(OTHER THAN AS DOCTOR, SURGEON, OR NURSE)\nThe questions should be answered as fully as possible, especially when an application for a passport may later be necessary.\nAll answers must be in handwriting of applicant,\nI. Name in full\nSara Gertrude Bush\nTelephone No Marlo-4080 J\n2. Present Address\n1283 Donald Avenue\nCleveland\nOhio\n(Number and Street)\n(City)\n(State)\n(a) If any changes of residence since August I, 1914, give these in full with dates.\ne\nMayport Indiana March-1915\n(b) What is your present business or profession? (Be specific.)\nGraduate nurse (Industrial)\n+\n(c) What previous business or professional experience have you had, stating nature, places and principal\nT\ndates thereof\nSchool teacher Jefferson. Co. Pa. 1907 1910\n(d) Have you ever lived in Europe? If so, give names of European countries in which you have resided\nand respective dates of residence in each.\n(e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits.\n(f)\nSince August I, 1914, have you applied for a United States passport? If so, state whether application\nwas granted, denied or withdrawn.\n3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state\nmilitia.\n(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex-\namining official.\nFor enrollment in Red Cross nursing service\n(b) Were you accepted, rejected, or is result of examination pending?\nAccepted\n4. Date of birth\n1888\n,\nNov.\n13th (a) Place of birth Pa.\nYear\nMonth\nDay\n(b) Full name of father.\nJohn Anderson Bush\n(c) Birthplace of father Indiana Co. Pa\n(d) Nationality of father American\n(e) If father foreign born, whether naturalized and when\n(f) Full maiden name of mother\nElla Parantha Mohney\n(g) Birthplace of mother Jefferson. Co. Pa.\n(h) Nationality of mother\nAmerican\n(i) If mother foreign born, whether naturalized and when\n(j) Full name and nationality of paternal grandfather Phillip Bush\nAmerican\n(k) Full maiden name and nationality of paternal grandmother. Catherine Siomger Ameriom\n(1) Full name and nationality of maternal grand father John Mohney\nAmerican\n(m) Full maiden name and nationality of maternal grandmother. Mary Ellen Mank Amer..\n2\n(n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives,\nif any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State\nnature and places of employment of each of such relatives not now in such war service.\n6\n(o)\nNames of all relatives nearer than second cousins in the war service of any of the allies of the United\nStates, specifying which ally in every case."
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