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I C B 1 1045 OCT. 1943 AMERICAN RED CROSS NURSING SERVICE ANNUAL QUESTIONNAIRE-194 asy Red Cross If you have changed your last name Badge number 6154 since contacting us, please check here. Name in full Du Brau Clasa Edith (last) (first) (middle) Tel. No. Kenene 0950 If married, give maiden name Date of birth July 13-1882 Marital status Husband's name (single, married, widowed, divorced) Permanent address 839 (street) Beyestere (city) st. -Bestne man (county) (state) Present address 839 Boylstone (street) ST. (city) Bestone puffath (county) man (state) a Notify national headquarters immediately if you change your address. Give name and address of nearest relative or friend in the United States: + mere Herfert (name) W. Carwell (address) Marraganethic R.J. (relationship) sister 5 Are you employed in nursing at the present time? Yes No If employed, check the type of work you are doing and fill in below the title of your position and the name and address of the agency or institution: Institutional Public Health Industrial Private Duty Other at present doing quinite muring not restending If not employed what type of rursing would you prefer to render? milling to help out whenever IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX AVAILABILITY FOR SERVICE WITH THE ARMED FORCES Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40. For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She may be single or married, but if married she must have no dependents under 14 years of age. If eligible and not already in service with the armed forces, are you Immediately available? Available in the near future? (specify date) Not available, for the following reason? (specify) Do you have any dependents under 14 years of age? Yes No AVAILABILITY FOR SERVICE WITH CIVILIANS If qualified and not already doing so, will you be available: To teach Red Cross Home Nursing classes? To teach volunteer nurse's aides? To a take Red Cross emergency assignment? yes To serve overseas caring for civilians ? Have you ever served with the Red Cross in a disaster? Yes No If yes, specify type of disaster Halifax Disaster 1917

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Page context
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    "ocrText": "I\nC\nB\n1\n1045\nOCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-194\nasy\nRed Cross\nIf you have changed your last name\nBadge number 6154\nsince contacting us, please check here.\nName in full Du Brau Clasa Edith\n(last)\n(first)\n(middle)\nTel. No. Kenene 0950\nIf married, give maiden name\nDate of birth July 13-1882\nMarital status\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 839 (street) Beyestere (city) st. -Bestne\nman\n(county)\n(state)\nPresent address 839 Boylstone (street) ST. (city) Bestone puffath (county) man\n(state)\na\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\n+\nmere Herfert (name) W. Carwell (address) Marraganethic R.J. (relationship) sister\n5\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nat present doing quinite muring not restending\nIf not employed what type of rursing would you prefer to render?\nmilling to help out whenever\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason?\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nTo a\ntake Red Cross emergency assignment? yes\nTo serve overseas caring for civilians ?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster Halifax Disaster\n1917"
}