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29735
prot
s
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Form No. 469-(2)
e
THE AMERICAN RED CROSS
1
ENROLLMENT FORM
M
W
Pacific
To
THE DIVISION OF TRANSPORTATION,
From
Nursing Department
BUREAU OF PERSONNEL.
in
Date Dec. 4, 1918.
Approval of Director,
Approved
m
Bureau of Personnel
1. Name
Forster, Charlotto,
2. Address
o/o Mr. La H. Forstoz, lith and Mahn StS., Washington, D. a.
3. Temporary address, if any
449 Grend View St., Los Angolos, Oal. - until oal led for
service.
4. Going to what countries
France
5. Nature of work Enrolled lied Cross Nurse
6. Suggested rank
7. Length of stay (six months or over?)
1 your-or-more
8. Proposed approximate date of departure
Booked
Sailed
9. Cable number in compliance with which above is being sent
10. Is appointee volunteer'
No
11. If not volunteer, what salary per month is promised $ 70.00
12. To begin day of departuro for
H.Y.
13. What allowance, if any, for transportation in United States? $
To Now York and retum
14. What allowance, if any, for transportation (steamship) ? $ To destination and return
15. What allowance, if any, for living expenses prior to departure? $ 4.00 day fr en date requested to re-
port in New York to day of sailing.
16. What allowance, if any, for uniform equipment ? $ Yes. requisitionod at Now York office.
17. What allowance, if any, for living expenses abroad ? $
Yes. regulation
lowame.
18. Is there to be an assignment of part or all of salary ?
19. Has the proper form been sent to the Life ExtensionInstitute?
Division of Transportation,
PLEASE LEAVE THE FOLLOWING LINES BLANK.
Correspondence checked:
Note
Forms
Mailed
Clerk of the
Court at
Application for passport filed
Date
Issued
Reservation
Cancelled
Cabled
Cancelled
2
g
Date of Birth!- March 18, 1878
J
3
of
Page data
- Page
- 35
- Source index
- 0
- Type
- photo
- Media ID
- 78147995172137a2
- Size
- unknown
Document data
- ID
- 2661482
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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Page context
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"ocrText": "F\n29735\nprot\ns\n+\nForm No. 469-(2)\ne\nTHE AMERICAN RED CROSS\n1\nENROLLMENT FORM\nM\nW\nPacific\nTo\nTHE DIVISION OF TRANSPORTATION,\nFrom\nNursing Department\nBUREAU OF PERSONNEL.\nin\nDate Dec. 4, 1918.\nApproval of Director,\nApproved\nm\nBureau of Personnel\n1. Name\nForster, Charlotto,\n2. Address\no/o Mr. La H. Forstoz, lith and Mahn StS., Washington, D. a.\n3. Temporary address, if any\n449 Grend View St., Los Angolos, Oal. - until oal led for\nservice.\n4. Going to what countries\nFrance\n5. Nature of work Enrolled lied Cross Nurse\n6. Suggested rank\n7. Length of stay (six months or over?)\n1 your-or-more\n8. Proposed approximate date of departure\nBooked\nSailed\n9. Cable number in compliance with which above is being sent\n10. Is appointee volunteer'\nNo\n11. If not volunteer, what salary per month is promised $ 70.00\n12. To begin day of departuro for\nH.Y.\n13. What allowance, if any, for transportation in United States? $\nTo Now York and retum\n14. What allowance, if any, for transportation (steamship) ? $ To destination and return\n15. What allowance, if any, for living expenses prior to departure? $ 4.00 day fr en date requested to re-\nport in New York to day of sailing.\n16. What allowance, if any, for uniform equipment ? $ Yes. requisitionod at Now York office.\n17. What allowance, if any, for living expenses abroad ? $\nYes. regulation\nlowame.\n18. Is there to be an assignment of part or all of salary ?\n19. Has the proper form been sent to the Life ExtensionInstitute?\nDivision of Transportation,\nPLEASE LEAVE THE FOLLOWING LINES BLANK.\nCorrespondence checked:\nNote\nForms\nMailed\nClerk of the\nCourt at\nApplication for passport filed\nDate\nIssued\nReservation\nCancelled\nCabled\nCancelled\n2\ng\nDate of Birth!- March 18, 1878\nJ\n3\nof"
}