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FORM 1037
REV. FEB. 1941
AMERICAN RED CROSS NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out in applicant's handwriting and each question answered fully)
1. Name of applicant in full
Doyle, Virginia Mae
If married, give maiden name
2. Permanent address
Apt. L, 1211 N. 7th St. St. Louis, MO.
(Street)
(City)
(County)
(State)
3. Probable address for one year
Apt. 1, 1211 N. 7th St., St. Louis, Mo.
(Street)
(City)
(County)
(State)
4. Name and permanent address of nearest relative or friend residing in the United States:
Klaisner, Mrs. E.J. 3151 S. Crawford, Chicago, Ill.
(Sister)
(Name)
(Address)
(Relationship)
8. What languages other than English do you
5. Race
6. Present Marital Status
7. Citizenship
speak?
2 White
Single
Native born
None
German
Negro
Married
Naturalized
Spanish
Scandinavian
Other
Widowed
Non citizen
French
Polish
Divorced
Italian
Other
Catholic Sister
9.
Date of birth Apr. 3, 1906
Place of birth Marine, Ill.
Is Father a citizen of the
Yes
United States?
No
10. General education (prior to entering nursing):
Did you graduate from high school
Yes If no, how many years of high school do you lack?
No
What college or university education did you have prior to entering nursing?
None or less
1 year;
2 years;
3 years;
Bachelors
5 Masters
PH.D.
than 1 year;
Degree;
Degree;
11. Nursing Education:
a. School of nursing from which
graduated
St. John's Hospital
Springfield
Illinois
(Name)
(City)
(State)
Date of graduation Oct. 26
1927
Length of course:
5 years;
3 years;
(Specify Other)
b. Undergraduate affiliations:
Clinical
Hospital or Organization
City and State
specialty
No. months
(1)
(2)
(3)
c. Postgraduate clinical courses (Do not include academic work or employment)
Clinical
Hospital or Organization
City and State
specialty
No. months
(1)
Grace Hospital
Detroit, Mich.
Anesthesia
4 months
(2)
(3)
d. Academic study since graduation from School of Nursing:
College or University
City and State
Number of full time
Number of
academic years
points
(1)
(2)
(3)
e. Check all degrees obtained
Bachelors
Masters
PH. D.
Certificate in Public Health
subsequent to entering training:
Degree;
Degree;
Nursing
f. In which major field was your academic study?
1 Institutional
Public Health
Non nursing (specify)
Other (specify)
(Over)

Page data

Page: 72
Source index: 0
Type: photo
Media ID: d9c3aebf59aaa216
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Document data

ID: 2661390
Core: doc
Type: document

DTO data

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Document source extras

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        "day": 18,
        "logicalDate": "1945-09-18",
        "month": 9,
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Page context

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    "ocrText": "FORM 1037\nREV. FEB. 1941\nAMERICAN RED CROSS NURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out in applicant's handwriting and each question answered fully)\n1. Name of applicant in full\nDoyle, Virginia Mae\nIf married, give maiden name\n2. Permanent address\nApt. L, 1211 N. 7th St. St. Louis, MO.\n(Street)\n(City)\n(County)\n(State)\n3. Probable address for one year\nApt. 1, 1211 N. 7th St., St. Louis, Mo.\n(Street)\n(City)\n(County)\n(State)\n4. Name and permanent address of nearest relative or friend residing in the United States:\nKlaisner, Mrs. E.J. 3151 S. Crawford, Chicago, Ill.\n(Sister)\n(Name)\n(Address)\n(Relationship)\n8. What languages other than English do you\n5. Race\n6. Present Marital Status\n7. Citizenship\nspeak?\n2 White\nSingle\nNative born\nNone\nGerman\nNegro\nMarried\nNaturalized\nSpanish\nScandinavian\nOther\nWidowed\nNon citizen\nFrench\nPolish\nDivorced\nItalian\nOther\nCatholic Sister\n9.\nDate of birth Apr. 3, 1906\nPlace of birth Marine, Ill.\nIs Father a citizen of the\nYes\nUnited States?\nNo\n10. General education (prior to entering nursing):\nDid you graduate from high school\nYes If no, how many years of high school do you lack?\nNo\nWhat college or university education did you have prior to entering nursing?\nNone or less\n1 year;\n2 years;\n3 years;\nBachelors\n5 Masters\nPH.D.\nthan 1 year;\nDegree;\nDegree;\n11. Nursing Education:\na. School of nursing from which\ngraduated\nSt. John's Hospital\nSpringfield\nIllinois\n(Name)\n(City)\n(State)\nDate of graduation Oct. 26\n1927\nLength of course:\n5 years;\n3 years;\n(Specify Other)\nb. Undergraduate affiliations:\nClinical\nHospital or Organization\nCity and State\nspecialty\nNo. months\n(1)\n(2)\n(3)\nc. Postgraduate clinical courses (Do not include academic work or employment)\nClinical\nHospital or Organization\nCity and State\nspecialty\nNo. months\n(1)\nGrace Hospital\nDetroit, Mich.\nAnesthesia\n4 months\n(2)\n(3)\nd. Academic study since graduation from School of Nursing:\nCollege or University\nCity and State\nNumber of full time\nNumber of\nacademic years\npoints\n(1)\n(2)\n(3)\ne. Check all degrees obtained\nBachelors\nMasters\nPH. D.\nCertificate in Public Health\nsubsequent to entering training:\nDegree;\nDegree;\nNursing\nf. In which major field was your academic study?\n1 Institutional\nPublic Health\nNon nursing (specify)\nOther (specify)\n(Over)"
}

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