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I 6. Check all degrees obtained since entering training: Bachelor's Degree Master's Degree Certificate in Public Health Nursing 7. In which major field was your academic study? Institutional Public Health Other (specify) Non-nursing (specify) Courses in pi inciples of teaching Brincing les and Methode f Sending Health Courses in practice teaching (type) none State teacher's certificate? Where? Foreign languages spoken none 1V. EXPER1ENCE \Hospital or Organization City and State Nature of work Dates Persongin Charge United verity Nirsan Crescrition Shil i.e 7 " " Childrena fish Public less thing half nouse 1934-36 1937-40 Miss Kut Juliabled D " 42 Mcs 7 a 5 p - (For teaching experience indicate: elementary, secondary, normal, college, nursing, or other) Have you taught Rad Cross Home Nursing (formerly Home Hygiene and Care of the Sick)? us Chapter City and State Type Groups Dates V. EMPLOYMENT BASIS 1. Type of work preferred Rural Urban Will you accept either? 2. What State or localities do you prefer? 3. When will you be available? 4. Can you drive a car? yes Do you own a car? no 5. What dependents or family responsibilities do you have? none 6. Name of nearest relative to be notified in case of accident (relationship and address) Mr W PDell - father with Hellam tenna 7. Give name of placement service, if registered one 8. May we approach your present employer for references? 9. Do you have good health? yes 10. When did you have your last physical examination? 1943. Remarks: (Please attach photograph of yourself, taken within the past two years.) Cly-hoth ($ignature A of applicant) Diell Date 10/18/43

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Document source extras
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Page context
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    "ocrText": "I\n6. Check all degrees obtained since entering training:\nBachelor's Degree\nMaster's Degree\nCertificate in Public Health Nursing\n7. In which major field was your academic study?\nInstitutional\nPublic Health\nOther (specify)\nNon-nursing (specify)\nCourses in pi inciples of teaching\nBrincing les and Methode f Sending Health\nCourses in practice teaching (type)\nnone\nState teacher's certificate?\nWhere?\nForeign languages spoken\nnone\n1V. EXPER1ENCE\n\\Hospital or Organization\nCity and State\nNature of work Dates Persongin Charge\nUnited verity Nirsan Crescrition\nShil i.e\n7\n\"\n\"\nChildrena fish\nPublic less thing\nhalf nouse 1934-36 1937-40 Miss Kut Juliabled\nD\n\"\n42 Mcs\n7\na\n5\np\n-\n(For teaching experience indicate: elementary, secondary, normal, college, nursing, or other)\nHave you taught Rad Cross Home Nursing (formerly Home Hygiene and Care of the Sick)? us\nChapter\nCity and State\nType Groups\nDates\nV. EMPLOYMENT BASIS\n1. Type of work preferred Rural\nUrban\nWill you accept either?\n2. What State or localities do you prefer?\n3. When will you be available?\n4. Can you drive a car?\nyes\nDo you own a car?\nno\n5. What dependents or family responsibilities do you have? none\n6. Name of nearest relative to be notified in case of accident (relationship and address)\nMr W PDell - father with Hellam\ntenna\n7. Give name of placement service, if registered one\n8. May we approach your present employer for references?\n9. Do you have good health? yes\n10. When did you have your last physical examination? 1943.\nRemarks:\n(Please attach photograph\nof yourself, taken within\nthe past two years.)\nCly-hoth ($ignature A of applicant) Diell\nDate 10/18/43"
}