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Revised May 20, 1918.
Top Sheet
Upper portion for Divisional Record. Also see last portion of
application form.
Southwestern
Recommended by
Division for enrollment under Requisition Nurse
If not American citizen, so state, and give citizenship
Is applicant available leaving home two weeks from date full papers are rec'd
in Washington? Yes
Name
Miss Florence Brandt
Street Address St. Louis Baptist Hospital
City
St. Louis, Mo.
Temporary Address to what date June 1 1919
4461 Olive St.. St. Louis.
Please check or fill out blanks where possible
Languages Spoken
Location of
Proposed length of stay
One year
E-Excellent
Service desired
Full Volunteer
No
G-Good F-Fair
Volunteer with expenses met by Red Cross no
Is allowance for living abroad to be left to
discretion of foreign Commission? yes
English only
Allowance for living abroad if not left to
discretion of foreign Commission?
sant
Salary over expense allowance if anyNurse's Sal.
Allowance for living prior to departure Yes
Requisition for uniform and equipment
Allowance for transportation overseas and
return
Yes
Allowance for transportation in U. S. and
return
Yes
Physical Report
Age
26
Loyalty investigation conducted by (Name of
Date examined
Date Reported
agency employed, if any)
May 2/19
and Report
Dr. Pernoud
Approved
List of Loyalty indorsements:
Dr. C. C. Morris, St. Louis Baptist Hospital, St. Louis, Mo.
Dr. J. C. Bram, St. Louis Baptist Hospital, St. Louis, Mo.
Dr. B. Dorsey, Metropolitan Bldg., St. Louis, Mo.
Have passport application and pictures been forwarded
Date
Headquarters Record (Initial, date, and "O.K. 11 where acceptable)
File Record
Classification
Date
Referred to
Full papers
Provisional Enrollment
War Dept.
Physical
Actual Enrollment
Remarks
(Form S W Per 1602-918)
Page data
- Page
- 73
- Source index
- 0
- Type
- photo
- Media ID
- 818da2f0b67dc49e
- Size
- unknown
Document data
- ID
- 2661388
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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"collections": [
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Document source extras
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"url": "https://catalog.archives.gov/id/2661388",
"naId": 2661388,
"coverageEndDate": {
"day": 1,
"logicalDate": "1925-04-01",
"month": 4,
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"logicalDate": "1918-08-21",
"month": 8,
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},
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Page context
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"ocrText": "is\nRevised May 20, 1918.\nTop Sheet\nUpper portion for Divisional Record. Also see last portion of\napplication form.\nSouthwestern\nRecommended by\nDivision for enrollment under Requisition Nurse\nIf not American citizen, so state, and give citizenship\nIs applicant available leaving home two weeks from date full papers are rec'd\nin Washington? Yes\nName\nMiss Florence Brandt\nStreet Address St. Louis Baptist Hospital\nCity\nSt. Louis, Mo.\nTemporary Address to what date June 1 1919\n4461 Olive St.. St. Louis.\nPlease check or fill out blanks where possible\nLanguages Spoken\nLocation of\nProposed length of stay\nOne year\nE-Excellent\nService desired\nFull Volunteer\nNo\nG-Good F-Fair\nVolunteer with expenses met by Red Cross no\nIs allowance for living abroad to be left to\ndiscretion of foreign Commission? yes\nEnglish only\nAllowance for living abroad if not left to\ndiscretion of foreign Commission?\nsant\nSalary over expense allowance if anyNurse's Sal.\nAllowance for living prior to departure Yes\nRequisition for uniform and equipment\nAllowance for transportation overseas and\nreturn\nYes\nAllowance for transportation in U. S. and\nreturn\nYes\nPhysical Report\nAge\n26\nLoyalty investigation conducted by (Name of\nDate examined\nDate Reported\nagency employed, if any)\nMay 2/19\nand Report\nDr. Pernoud\nApproved\nList of Loyalty indorsements:\nDr. C. C. Morris, St. Louis Baptist Hospital, St. Louis, Mo.\nDr. J. C. Bram, St. Louis Baptist Hospital, St. Louis, Mo.\nDr. B. Dorsey, Metropolitan Bldg., St. Louis, Mo.\nHave passport application and pictures been forwarded\nDate\nHeadquarters Record (Initial, date, and \"O.K. 11 where acceptable)\nFile Record\nClassification\nDate\nReferred to\nFull papers\nProvisional Enrollment\nWar Dept.\nPhysical\nActual Enrollment\nRemarks\n(Form S W Per 1602-918)"
}