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UZG
NATIONAL OFFICERS
FORM 1045 REV. 2-16-31
HERBERT HOOVER, PRESIDENT
CENTRAL COMMITTEE
ROBERT W. DE FOREST. VICE PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
CALVIN COOLIDGE. VICE PRESIDENT
CHARLES EVANS HUGHES. VICE PRESIDENT
THE AMERICAN RED CROSS
MRS. AUGUST BELMONT
CORNELIUS N. BLISS
MABEL T. BOARDMAN
THOMAS D. THACHER, COUNSELOR
NATIONAL HEADQUARTERS
JOSEPH P. COTTON
OGDEN L. MILLS. TREASURER
MRS. HENRY P. DAVISON
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D.C.
MRS. FRANK v. HAMMAR
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
GUSTAVUS D. POPE
JOHN BARTON PAYNE, CHAIRMAN
MRS. HENRY R. REA
JAMES L. FIESER. VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
JOHN D. RYAN
ERNEST P. BICKNELL. VICE CHAIRMAN
GEORGE E. SCOTT
JAMES K. McCLINTOCK, VICE CHAIRMAN
HENRY UPSON SIMS
THOMAS D. THACHER
ELIOT WADSWORTH
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in enclosed envelope, at the earliest possible date.
IMPORTANT:
In order to render prompt service
Yours sincerely,
in time of disaster, enrolled Red Cross
Chairman or
Nurses should report at once to the
Secretary.
Secretary of the Local Committee under
which they are enrolled. Do not forget
Local Committee.
the address of the Secretary
Margery E Gagan true Forge
Jr
Name in full
If married, give husband's name
James J yagani
Permanent address 1559 STREET, ETC. clay Sam CITY Francisco COUNTY Calef STATE
Probable address for the next year
Same
STREET. ETC.
Telephone No gray 8909
CITY
COUNTY
STATE
Name and address of nearest relative or friend, in United States, through whom you may
Mrs H. E. Force St Paul Theback (Mother)
be communicated with in an emergency. (State relationship)
Underline the type of work
you are now doing Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital U.S. Indian
Service - Public Health - Institutional Private Duty - Industrial Office Nurse
-
Registrar
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?
No
Have you ever been?
no
Indicate present physical condition good
war
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Badge No 12862
Current date
may 21-1931 (only
NOTE.--If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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"ocrText": "UZG\nNATIONAL OFFICERS\nFORM 1045 REV. 2-16-31\nHERBERT HOOVER, PRESIDENT\nCENTRAL COMMITTEE\nROBERT W. DE FOREST. VICE PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. VICE PRESIDENT\nCHARLES EVANS HUGHES. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMRS. AUGUST BELMONT\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nTHOMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nJOSEPH P. COTTON\nOGDEN L. MILLS. TREASURER\nMRS. HENRY P. DAVISON\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. HENRY R. REA\nJAMES L. FIESER. VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nERNEST P. BICKNELL. VICE CHAIRMAN\nGEORGE E. SCOTT\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nHENRY UPSON SIMS\nTHOMAS D. THACHER\nELIOT WADSWORTH\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman or\nNurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary\nMargery E Gagan true Forge\nJr\nName in full\nIf married, give husband's name\nJames J yagani\nPermanent address 1559 STREET, ETC. clay Sam CITY Francisco COUNTY Calef STATE\nProbable address for the next year\nSame\nSTREET. ETC.\nTelephone No gray 8909\nCITY\nCOUNTY\nSTATE\nName and address of nearest relative or friend, in United States, through whom you may\nMrs H. E. Force St Paul Theback (Mother)\nbe communicated with in an emergency. (State relationship)\nUnderline the type of work\nyou are now doing Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital U.S. Indian\nService - Public Health - Institutional Private Duty - Industrial Office Nurse\n-\nRegistrar\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nNo\nHave you ever been?\nno\nIndicate present physical condition good\nwar\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No 12862\nCurrent date\nmay 21-1931 (only\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}