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Hawaii unit
J
Confidential
AMERICAN RED CROSS Refund Record h
FORM 1219
REV. JUNE 1942
Please return
M
APPLICATION FOR EMPLOYMENT - NURSING PERSONNEL
I. PERSONAL
Badge (No 110412
Name in full miss June M. Quishane
(H.D.
(M198 OR MRS.)
(IF MARRIED. GIVE MAIDEN NAME ALSO)
Not enrolled
Present Hungerford Avenue Degannes, Michigan (STATE Tel. No.
315
USTREED
(CITY)
u
Permanent address308 Hungerford Avenue, negannee, Michigan Tel.
No 315
STREET
(CITY)
(STATE)
Citizenship American
Color White
Place of birth dishpeming mishigan
Present position general (TITLE) duty staff
890smarth Date of birth August 31
(SALARY)
Twic City Hospital (ORGANIZATION) 215 Cyc st. neganne, michigan (ADDRESS)
Single
Widowed
Married
Divorced
II. PROFESSIONAL STATUS
States registered michigan
Current registration No.30645
1942
To what professional organizations do you belong? american Red. Cross,
St.Luke's Glumnge Osseciation
If not an enrolled Red Cross nurse, has your application for enrollment been submitted to
a
your Local Committee Red Cross Nursing Service? (NOT chapter committee)
When and to whom?
S
III. EDUCATION
p
1. Prior to entering school of nursing:
Name
City and State Dates Diploma-Degree
Major
High School Negaunce, Mich. 1934-1938 Diploma
Normal School
University
Other
2. School of nursing from) St:Lukes Hospital (NAME) School of nursing, marquette, Michigan (STATE
which you graduated)
Length of course
5 years
3 years
(Specify other) Date completed 1942-Sept.
3. Undergraduate affiliations:
Hospital or Organization
City and State
Clinical Specialty No. Months
(1) University Hospital
ann Arbon Michigan
gyncelogy rurgical
(2)
specialities
3
(3)
4. Postgraduate clinical courses: (-Do not include academic work or employment.)
Hospital or Organization
City and State
Clinical Specialty
Dates
(1)
(2)
(3)
5. Academic study since graduation from school of nursing:
College or University
City and State
Academic years
No. Points
2
(1)
(2)
(3)
Page data
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- 52
- Source index
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- Type
- photo
- Media ID
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Document data
- ID
- 2661222
- Core
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- Type
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"ocrText": "N\netc\nHawaii unit\nJ\nConfidential\nAMERICAN RED CROSS Refund Record h\nFORM 1219\nREV. JUNE 1942\nPlease return\nM\nAPPLICATION FOR EMPLOYMENT - NURSING PERSONNEL\nI. PERSONAL\nBadge (No 110412\nName in full miss June M. Quishane\n(H.D.\n(M198 OR MRS.)\n(IF MARRIED. GIVE MAIDEN NAME ALSO)\nNot enrolled\nPresent Hungerford Avenue Degannes, Michigan (STATE Tel. No.\n315\nUSTREED\n(CITY)\nu\nPermanent address308 Hungerford Avenue, negannee, Michigan Tel.\nNo 315\nSTREET\n(CITY)\n(STATE)\nCitizenship American\nColor White\nPlace of birth dishpeming mishigan\nPresent position general (TITLE) duty staff\n890smarth Date of birth August 31\n(SALARY)\nTwic City Hospital (ORGANIZATION) 215 Cyc st. neganne, michigan (ADDRESS)\nSingle\nWidowed\nMarried\nDivorced\nII. PROFESSIONAL STATUS\nStates registered michigan\nCurrent registration No.30645\n1942\nTo what professional organizations do you belong? american Red. Cross,\nSt.Luke's Glumnge Osseciation\nIf not an enrolled Red Cross nurse, has your application for enrollment been submitted to\na\nyour Local Committee Red Cross Nursing Service? (NOT chapter committee)\nWhen and to whom?\nS\nIII. EDUCATION\np\n1. Prior to entering school of nursing:\nName\nCity and State Dates Diploma-Degree\nMajor\nHigh School Negaunce, Mich. 1934-1938 Diploma\nNormal School\nUniversity\nOther\n2. School of nursing from) St:Lukes Hospital (NAME) School of nursing, marquette, Michigan (STATE\nwhich you graduated)\nLength of course\n5 years\n3 years\n(Specify other) Date completed 1942-Sept.\n3. Undergraduate affiliations:\nHospital or Organization\nCity and State\nClinical Specialty No. Months\n(1) University Hospital\nann Arbon Michigan\ngyncelogy rurgical\n(2)\nspecialities\n3\n(3)\n4. Postgraduate clinical courses: (-Do not include academic work or employment.)\nHospital or Organization\nCity and State\nClinical Specialty\nDates\n(1)\n(2)\n(3)\n5. Academic study since graduation from school of nursing:\nCollege or University\nCity and State\nAcademic years\nNo. Points\n2\n(1)\n(2)\n(3)"
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