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FORM 1045 REV. OCT.1943 AMERICAN RED CROSS NURSING SERVICE ANNUAL QUESTIONNAIRE-1944 Red Cross If you have changed your last name Badge number 20614 since contacting us, please check here. G Name in full Bush Garah gertrude Tel. No. Er0869 1b (last) (first) (middle) 7 If married, give maiden name Date of birth Nov 13-/888 + T Marital status Husband's name C (single, married, widowed, divorced) bus Permanent address 93150 Remingtonk ColunFranklin Ohio (street) (city) (county) (state) Present address same (street) (city) (county) (state) Notify national headquarters immediately if you change your address. Give name and address of nearest relative or friend in the United States: Mrs Dorothy Bush 3115 West 139th st Cleveland sister in - law (name) (address) (relationship) Are you employed in nursing at the present time Yes No If employed, check the type of work you are doing and fill in below the title of your position and the name and address of the agency or institution: Institutional Public Health Industrial Private Duty Other If not employed, what type of nursing would you prefer to render? IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX AVAILABILITY FOR SERVICE WITH THE ARMED FORCES Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40. For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She may be single or married, but if married she must have no dependents under 14 years of age. If eligible and not already in service with the armed forces, are you : Immediately available? Available in the near future? (specify date) Not available, for the following reason ? (specify) Do you have any dependents under 14 years of age? Yes No AVAILABILITY FOR SERVICE WITH CIVILIANS If qualified and not already doing so, will you be available: To teach Red Cross Home Nursing classes? To teach volunteer nurse's aides? To take a Red Cross emergency assignment? To serve overseas caring for civilians? yes C Have you ever served with the Red Cross in a disaster? Yes No If of disaster yes, specify type worldwar NOI. France 419114

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    "ocrText": "FORM 1045\nREV. OCT.1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nIf you have changed your last name\nBadge number 20614\nsince contacting us, please check here.\nG\nName in full Bush\nGarah\ngertrude\nTel. No. Er0869\n1b\n(last)\n(first)\n(middle)\n7\nIf married, give maiden name\nDate of birth Nov 13-/888\n+\nT\nMarital status\nHusband's name\nC\n(single, married, widowed, divorced)\nbus\nPermanent\naddress 93150 Remingtonk ColunFranklin\nOhio\n(street)\n(city)\n(county)\n(state)\nPresent address\nsame\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nMrs Dorothy Bush 3115 West 139th st Cleveland\nsister in - law\n(name)\n(address)\n(relationship)\nAre you employed in nursing at the present time Yes\nNo\nIf\nemployed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements:\nFor assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you :\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ?\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nyes\nC\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf of disaster\nyes, specify type worldwar NOI. France 419114"
}