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FORM 1045 REV. 2-16-31
a
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
ROBERT w. DE FOREST. VICE PRESIDENT
MRS. AUGUST BELMONT
CALVIN COOLIDGE, VICE PRESIDENT
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
MABEL T. BOARDMAN
CHARLES EVANS HUGHES, Vice PRESIDENT
JOSEPH P. COTTON
D
THOMAS D. THACHER, COUNSELOR
NATIONAL HEADQUARTERS
MRS. HENRY P. DAVISON
MRS. FRANK v. HAMMAR
OGDEN L. MILLS, TREASURER
WASHINGTON, D.C.
MAJ. GEN. M. w. IRELAND
-
MABEL T. BOARDMAN. SECRETARY
SAMUEL KNIGHT
OGDEN L. MILLS
GUSTAVUS D. POPE
NATIONAL EXECUTIVE OFFICERS
MRS. HENRY R. REA
REAR ADMIRAL CHARLES E. RIGGS
JOHN BARTON PAYNE, CHAIRMAN
JOHN D. RYAN
JAMES L. FIESER, VICE CHAIRMAN
GEORGE E. SCOTT
ERNEST P. BICKNELL, VICE CHAIRMAN
HENRY UPSON SIMS
THOMAS D. THACHER
JAMES K. McCLINTOCK, VICE CHAIRMAN
SLIOT WADSWORTH
3/14/91
P.
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in enclosed envelope, at the earliest possible date.
IMPORTANT:
In order to render prompt service
Yours sincerely
in time of disaster, enrolled Red Cross
Nurses should report at once to the
learnlyn, Schmoken Chairman Secretary.
or
Secretary of the Local Committee under
which they are enrolled. Do not forget
Besty Hospital Local Committee
the address of the Secretary.
Name in full miss Glice B. P. Conover
nework n.g.
If married, give husband's name
Permanent address 7 Hillside STREET, ETC. are Summit CITY Union COUNTY STATE
Probable address for the next year
> Hellide ave
STREET, ETC.
Telephone No. 6-005.5W
Summit
Union
CITY
COUNTY
higo. /STATE
Name and address of nearest rolative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Underline
Brother the Reo type of T.a. work Conover Bernarderile hig
you are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian
Service - Public Health - Institutional - Private Duty - Industrial - Office Nurse -
Registrar. none retered
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? ho
Have you ever boon? no
Indicate present physical condition scottorood (66 in buaz
Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Hfosible
Badge No. 12319
Current date march 17th 1931
NOTE. -- If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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"ocrText": "FORM 1045 REV. 2-16-31\na\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nCHARLES EVANS HUGHES, Vice PRESIDENT\nJOSEPH P. COTTON\nD\nTHOMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nMRS. FRANK v. HAMMAR\nOGDEN L. MILLS, TREASURER\nWASHINGTON, D.C.\nMAJ. GEN. M. w. IRELAND\n-\nMABEL T. BOARDMAN. SECRETARY\nSAMUEL KNIGHT\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nNATIONAL EXECUTIVE OFFICERS\nMRS. HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN BARTON PAYNE, CHAIRMAN\nJOHN D. RYAN\nJAMES L. FIESER, VICE CHAIRMAN\nGEORGE E. SCOTT\nERNEST P. BICKNELL, VICE CHAIRMAN\nHENRY UPSON SIMS\nTHOMAS D. THACHER\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nSLIOT WADSWORTH\n3/14/91\nP.\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely\nin time of disaster, enrolled Red Cross\nNurses should report at once to the\nlearnlyn, Schmoken Chairman Secretary.\nor\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nBesty Hospital Local Committee\nthe address of the Secretary.\nName in full miss Glice B. P. Conover\nnework n.g.\nIf married, give husband's name\nPermanent address 7 Hillside STREET, ETC. are Summit CITY Union COUNTY STATE\nProbable address for the next year\n> Hellide ave\nSTREET, ETC.\nTelephone No. 6-005.5W\nSummit\nUnion\nCITY\nCOUNTY\nhigo. /STATE\nName and address of nearest rolative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline\nBrother the Reo type of T.a. work Conover Bernarderile hig\nyou are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian\nService - Public Health - Institutional - Private Duty - Industrial - Office Nurse -\nRegistrar. none retered\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? ho\nHave you ever boon? no\nIndicate present physical condition scottorood (66 in buaz\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? Hfosible\nBadge No. 12319\nCurrent date march 17th 1931\nNOTE. -- If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}