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F
/
Pat please ways may
S
FORM 1045
REV. OCT. 1943
+
Pin -
AMERICAN RED CROSS
have
NURSING SERVICE
ep
ANNUAL QUESTIONNAIRE-1944
5
Red Cross
If you have changed your last name
Badge number 90882
since contacting us, please check here.
Name in full 70to t stephanie (first) Famice (middle)
an
Tel. No. 66506
(last)
If married, give maiden name not married
Date of birth Dec. 8, 1906
Marital status.
Husband's name
(single, married, widowed, divorced)
F
Permanent address none
(street)
(city)
(county)
(state)
Present address 1742 nuranu are Honolulu 3 T.H.
(street)
(city)
(county)
(state)
Notify national headquarters immediately if you change your address.
Give name and address of nearest relative or friend in the United States:
mrs. Rose alexander. 1121 East Blad. Baton Rouge ,ha Sester
(name)
(address)
(relationship)
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
Priyate Duty
Other
Sacred Gearts Emergency Hosp, office of Civilian Defence.
nurse anesthetist
If not employed, what type of nursing would you prefer to render?
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 ? already employed in essential work.
(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 serve overseas caring for civilians? In this Service now
To take a Red Cross emergency assignment?
Have you ever served with the Red Cross in a disaster? Yes
No
MAUT2 SA 251%
If yes, specify type of disaster
220 13 ban
nobl W
&
.H.T ,Ae
82
Page data
- Page
- 19
- Source index
- 0
- Type
- photo
- Media ID
- acc0890d17d1643f
- Size
- unknown
Document data
- ID
- 2661485
- Core
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- 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\n/\nPat please ways may\nS\nFORM 1045\nREV. OCT. 1943\n+\nPin -\nAMERICAN RED CROSS\nhave\nNURSING SERVICE\nep\nANNUAL QUESTIONNAIRE-1944\n5\nRed Cross\nIf you have changed your last name\nBadge number 90882\nsince contacting us, please check here.\nName in full 70to t stephanie (first) Famice (middle)\nan\nTel. No. 66506\n(last)\nIf married, give maiden name not married\nDate of birth Dec. 8, 1906\nMarital status.\nHusband's name\n(single, married, widowed, divorced)\nF\nPermanent address none\n(street)\n(city)\n(county)\n(state)\nPresent address 1742 nuranu are Honolulu 3 T.H.\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nmrs. Rose alexander. 1121 East Blad. Baton Rouge ,ha Sester\n(name)\n(address)\n(relationship)\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\nPriyate Duty\nOther\nSacred Gearts Emergency Hosp, office of Civilian Defence.\nnurse anesthetist\nIf not employed, what type of nursing would you prefer to render?\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 ? already employed in essential work.\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 serve overseas caring for civilians? In this Service now\nTo take a Red Cross emergency assignment?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nMAUT2 SA 251%\nIf yes, specify type of disaster\n220 13 ban\nnobl W\n&\n.H.T ,Ae\n82"
}