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12. PROFESSIONAL AFFILIATIONS:
Of what State Nurses' Association are you a member?*
Mr
If you have only recently applied for membership, to whom did you pay your dues?
(Name)
(Title and organization)
(Address)
In what State are you registered?
Michigan
Year of registration 1942 onlist
13. Present Position:
M
J.
Field of Nursing
Major Responsibilities
u
Institutional
Private Duty
Administration
General Duty
2
Public Health
Other (specify below)
Supervision
Private Duty
ary
S
Industrial
Other (Specify below)
e
Teaching
14. Give in order positions held since graduation. Star present position:
Position
Organization or Hospital
City
State
Dates
(5)
p
a
S
15. Red Cross Status:
Are you willing to take the oath of allegiance? yes
Are you planning to teach the course in Red Cross Home Nursing? no
If not, would you like to teach it? yes, I think PU.
Although 1 understand my response at the time of a call is voluntary, by applying for enrollment I signify that I wish
to
make myself available for the emergency nursing needs of my country. I understand that this may mean service with
the Red Cross, or, in the event of such a national disaster as war, with the Army or Navy. For military assignment I prefer
the X Army Nurse Corps; Navy Nurse Corps; Either as needed. I will be available for service in the near
future.
Sept.22, 1942 Date Available successfully pass my state boardehaminetimes.
Date July 31,1942
Signature of nurse June m. Dut Shane
Membership in a District Nurses' Association carries with it membership in the State Nurses' Association and the American Nurses' Association.
Membership in your Alumnae Association, provided you live in the District in which it is located, carries with it membership in the State Nurses'
Association and the American Nurses' Association.
of
SPACE BELOW TO BE FILLED IN BY COMMITTEE
PLEASE DO NOT USE THIS SPACE
APPROVED
The recommendations of the Local Committee on
Red Cross Nursing Service should be indicated below,
over the signature of at least two members of the Com-
Mary Beard
mittee.
Director Red Cross Nursing Service
APPROVED:
NOT APPROVED:
C Lanne SaBante R.n
ms. Clin Kepler
Name of Committee marquette
1104120CT23'42
Date
Date Cech 17, 1442
No.
Enrolled
AT N.M. - OCT 2 1 1942
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Document data
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"ocrText": "12. PROFESSIONAL AFFILIATIONS:\nOf what State Nurses' Association are you a member?*\nMr\nIf you have only recently applied for membership, to whom did you pay your dues?\n(Name)\n(Title and organization)\n(Address)\nIn what State are you registered?\nMichigan\nYear of registration 1942 onlist\n13. Present Position:\nM\nJ.\nField of Nursing\nMajor Responsibilities\nu\nInstitutional\nPrivate Duty\nAdministration\nGeneral Duty\n2\nPublic Health\nOther (specify below)\nSupervision\nPrivate Duty\nary\nS\nIndustrial\nOther (Specify below)\ne\nTeaching\n14. Give in order positions held since graduation. Star present position:\nPosition\nOrganization or Hospital\nCity\nState\nDates\n(5)\np\na\nS\n15. Red Cross Status:\nAre you willing to take the oath of allegiance? yes\nAre you planning to teach the course in Red Cross Home Nursing? no\nIf not, would you like to teach it? yes, I think PU.\nAlthough 1 understand my response at the time of a call is voluntary, by applying for enrollment I signify that I wish\nto\nmake myself available for the emergency nursing needs of my country. I understand that this may mean service with\nthe Red Cross, or, in the event of such a national disaster as war, with the Army or Navy. For military assignment I prefer\nthe X Army Nurse Corps; Navy Nurse Corps; Either as needed. I will be available for service in the near\nfuture.\nSept.22, 1942 Date Available successfully pass my state boardehaminetimes.\nDate July 31,1942\nSignature of nurse June m. Dut Shane\nMembership in a District Nurses' Association carries with it membership in the State Nurses' Association and the American Nurses' Association.\nMembership in your Alumnae Association, provided you live in the District in which it is located, carries with it membership in the State Nurses'\nAssociation and the American Nurses' Association.\nof\nSPACE BELOW TO BE FILLED IN BY COMMITTEE\nPLEASE DO NOT USE THIS SPACE\nAPPROVED\nThe recommendations of the Local Committee on\nRed Cross Nursing Service should be indicated below,\nover the signature of at least two members of the Com-\nMary Beard\nmittee.\nDirector Red Cross Nursing Service\nAPPROVED:\nNOT APPROVED:\nC Lanne SaBante R.n\nms. Clin Kepler\nName of Committee marquette\n1104120CT23'42\nDate\nDate Cech 17, 1442\nNo.\nEnrolled\nAT N.M. - OCT 2 1 1942"
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