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Wyandattes Kaus
Coople Leaveuworth FORM 1045 C.2
REV. OCT. 1943
AMERICAN RED CROSS
oll
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
you
quatilion 101
Red Cross
visit
If you have changed your last name
Badge number 24572
since contacting us, please check here.
health
Name in
full Conover
Lydia
Tel. No.
(last)
(first)
(middle)
If married, give maiden name
Date of birth march, 9 1882
bebuloni to bma
Marital status
Husband's name
(single, married, widowed, divorced)
Permanent address 317 E. (street) 2nd 88. Rainfield (city) (county) Union new (state) Jersey
Present address IDID South 3rd Sx Leabenworth
Kansas
(street)
(city)
(county)
Notify national headquarters immediately if you change your address.
address
(state)
Give name and address of nearest relative or friend in the United States:
Mrs C (name) a. Borman 3172. (address) 2n282 Plainfield nJ. (relationship) (sisker)
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
sidnom
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
nI
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason?
see Health
(specify)
Do you have any dependents under 14 years of age? Yes
No
AVAILABILITY FOR SERVICE WITH CIVILIANS
BUJAV
3ry
If qualified and not already doing so, will you be available:
To teach Red Cross Home Nursing classes?
2
To teach volunteer nurse's aides?
To take a Red Cross emergency assignment?
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If yes, specify type of disaster
World War I 1917-1918 smaV) Averseas,
2
(edada)
(vili)
Page data
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- Type
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- Media ID
- 8f3f52ad01e8f0a6
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Document data
- ID
- 2661270
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "Wyandattes Kaus\nCoople Leaveuworth FORM 1045 C.2\nREV. OCT. 1943\nAMERICAN RED CROSS\noll\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nyou\nquatilion 101\nRed Cross\nvisit\nIf you have changed your last name\nBadge number 24572\nsince contacting us, please check here.\nhealth\nName in\nfull Conover\nLydia\nTel. No.\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth march, 9 1882\nbebuloni to bma\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 317 E. (street) 2nd 88. Rainfield (city) (county) Union new (state) Jersey\nPresent address IDID South 3rd Sx Leabenworth\nKansas\n(street)\n(city)\n(county)\nNotify national headquarters immediately if you change your address.\naddress\n(state)\nGive name and address of nearest relative or friend in the United States:\nMrs C (name) a. Borman 3172. (address) 2n282 Plainfield nJ. (relationship) (sisker)\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, 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\nsidnom\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: For 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.\nShe\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\nnI\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason?\nsee Health\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nBUJAV\n3ry\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\n2\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster\nWorld War I 1917-1918 smaV) Averseas,\n2\n(edada)\n(vili)"
}