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N D & / L e 5 FORM 1045 REV. 2-16-31 NATIONAL OFFICERS CENTRAL COMMITTEE L P HERBERT HOOVER, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN MRS. AUGUST BELMONT ROBERT w. DE FOREST, VICE PRESIDENT CORNELIUS N. BLISS a 0 CALVIN COOLIDGE, VICE PRESIDENT THE AMERICAN RED CROSS MABEL T. BOARDMAN JOSEPH P COTTON < CHARLES EVANS HUGHES, VICE PRESIDENT NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON THOMAS D. THACHER, COUNSELOR 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 HENRY UPSON SIMS ERNEST P. BICKNELL, VICE CHAIRMAN THOMAS D. THACHER JAMES K. MCCLINTOCK, VICE CHAIRMAN ELIOT WADSWORTH TS L a Dear Madam: FEB 22 1932 < 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 en 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 HELEN E. SHEARSTON, Chairman or Nurses should report at once to the Secretary. Secretary of the Local Committee under MARYLAND STATE AND LOCAL COMMITTEE which they are enrolled. Do not forget RED cross NURSING SERVICE Local Committee. the address of the Segretary. OF MARYLAND, PALTIMORE, MARYLAND. Name in full Lavenier rene Hovenfort If married, give husband's name Royal W. Teevenfort Permanent address 114 STREET, ETC. CITY Chevychange montgomery COUNTY Maryland STATE Probable address Some for the next year STREET, ETC. Telephone No. Wisconsin 3287f CITY COUNTY STATE Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Royal W. Teemenport I lusbad Underline the type of work 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. Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no. Have you ever been? yes Indicate present physical condition Excellent. coved not Would you respond to an emergency call in event of epidemic, disaster, war, etc.? leove Badge No. 37892 Current date april 12 1982 Family 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": "N\nD\n&\n/\nL\ne\n5\nFORM 1045 REV. 2-16-31\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nL\nP\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. AUGUST BELMONT\nROBERT w. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\na\n0\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nJOSEPH P COTTON\n<\nCHARLES EVANS HUGHES, VICE PRESIDENT\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nTHOMAS D. THACHER, COUNSELOR\nMRS. FRANK v. HAMMAR\nOGDEN L. MILLS, TREASURER\nWASHINGTON, D.C.\nMAJ. GEN. M. w. IRELAND\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\nHENRY UPSON SIMS\nERNEST P. BICKNELL, VICE CHAIRMAN\nTHOMAS D. THACHER\nJAMES K. MCCLINTOCK, VICE CHAIRMAN\nELIOT WADSWORTH\nTS\nL\na\nDear Madam:\nFEB 22 1932\n<\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\nen\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\nHELEN E. SHEARSTON,\nChairman or\nNurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nMARYLAND STATE AND LOCAL COMMITTEE\nwhich they are enrolled. Do not forget\nRED cross NURSING\nSERVICE Local\nCommittee.\nthe address of the Segretary.\nOF MARYLAND,\nPALTIMORE, MARYLAND.\nName in full Lavenier rene Hovenfort\nIf\nmarried, give husband's name Royal W. Teevenfort\nPermanent address 114 STREET, ETC. CITY Chevychange montgomery COUNTY Maryland STATE\nProbable address Some\nfor the next year\nSTREET, ETC.\nTelephone No. Wisconsin 3287f\nCITY\nCOUNTY\nSTATE\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nRoyal W. Teemenport I lusbad\nUnderline the type of work\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.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nno.\nHave you ever been? yes\nIndicate present physical condition Excellent.\ncoved not\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nleove\nBadge No. 37892\nCurrent date april 12 1982\nFamily\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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