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N I e FORM 1045 REV. 1-7-30 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 C ISS CORNELIUS N. BLISS THOMAS D. THACHER, COUNSELOR MABEL T BOARDMAN JOSEPH P. COTTON OGDEN L. MILLS, TREASURER NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON MABEL T. BOARDMAN, SECRETARY E. B. DOUGLAS WASHINGTON, D.C. MRS. FRANK v. HAMMAR MAJ. GEN M. w. IRELAND NATIONAL EXECUTIVE OFFICERS SAMUEL KNIGHT OGDEN L. MILLS JOHN BARTON PAYNE, CHAIRMAN 9/10/45 GUSTAVUS D. POPE JAMES L. FIESER, VICE CHAIRMAN MRS. HENRY R. REA ERNEST P. BICKNELL, VICE CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS JOHN D, RYAN JAMES K. MCCLINTOCK. VICE CHAIRMAN GEORGE E, SCOTT THOMAS D. THACHER ELIOT WADSWORTH at 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: Yours sincerely, In order to render prompt service Chairman or in time of disaster, enrolled Red Cross Olive M. Diederich, R. N. Secretary nurses should report at once to the 2157 Euc id Avenue Secretary of the Local Committee under Cleveland, 0. Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full majorie Zawlon Denison If married, give husband's name Ement Lee Permanent address (STREET, 21 mople ETC.), st. Willoughly (CITY) (COUNTY) Ghio (STATE) Probable address for the next year same (STREET, ETC.) Telephone 643R. No. Willoughby (CITY) Ohio (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) hurs H.C.Allen 505 Amith 46 rb 11. West Phuladelphia P.a (Sisti) Underline the type of work you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public Health Institutional Office Nurse Registrar. no work - - Private Duty - Industrial - - Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no Have you ever been? no. Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war etc. ? no Hand 3 children Badge No. 13119 Current date april 9th in 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": "N\nI\ne\nFORM 1045 REV. 1-7-30\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 C\nISS\nCORNELIUS N. BLISS\nTHOMAS D. THACHER, COUNSELOR\nMABEL T BOARDMAN\nJOSEPH P. COTTON\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nMABEL T. BOARDMAN, SECRETARY\nE. B. DOUGLAS\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMAJ. GEN M. w. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nSAMUEL KNIGHT\nOGDEN L. MILLS\nJOHN BARTON PAYNE, CHAIRMAN\n9/10/45\nGUSTAVUS D. POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS. HENRY R. REA\nERNEST P. BICKNELL, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D, RYAN\nJAMES K. MCCLINTOCK. VICE CHAIRMAN\nGEORGE E, SCOTT\nTHOMAS D. THACHER\nELIOT WADSWORTH\nat\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:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nOlive M. Diederich, R. N.\nSecretary\nnurses should report at once to the\n2157 Euc id Avenue\nSecretary of the Local Committee under\nCleveland, 0.\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nmajorie Zawlon Denison\nIf married, give husband's name\nEment Lee\nPermanent address\n(STREET,\n21 mople ETC.), st. Willoughly (CITY) (COUNTY) Ghio\n(STATE)\nProbable address for the next year\nsame\n(STREET, ETC.)\nTelephone 643R.\nNo.\nWilloughby (CITY) Ohio (COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nhurs H.C.Allen 505 Amith 46 rb 11. West Phuladelphia P.a (Sisti)\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth Institutional Office Nurse Registrar. no work\n- - Private Duty - Industrial - -\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nno\nHave you ever been?\nno.\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war etc. ?\nno\nHand 3 children\nBadge No. 13119\nCurrent date april 9th in 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"
}