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Form No. 200
Revised 2-15-18
DUPLICATE
AMERICAN RED CROSS
SERVICE ENROLLMENT APPLICATION
No.
(OTHER THAN AS DOCTOR, SURGEON, OR NURSE)
Date
The questions should be answered as fully as possible, especially when an application for a passport may later_be necessary.
All answers must be in handwriting of applicant.
I. Name in full Sara M. Gray
Telephone No. Intervale 575
Present
Address c/o Mrs. Snedden, 1564 Crotona Park; E. Br onx, N. Y. City, N.Y.
2.
(Number and Street)
(City)
(State)
(a) If any changes of residence since August I, 1914, give these in full with dates.
Hosp.
to
Jen.
N. Y. S. &C. Hosp., Aug, 1, 14 to Aug. 16. Union Hosp Bronx to Jen. '14
Present add. since
(b) What is your present business or profession? (Be specific.)
Private Nursing
(c) What previous business or professional experience have you had, stating nature, places and principal dates
thereof?
Worked as undergraduate of practical nurse in Unic on Hosp.
2456 Valentine Ave., Bronx.
(d) Have you ever lived in Europe? If so, give names of European countries in which you have resided
and respective dates of residence in each.
Yes. Ireland from birth until 21 years old
(e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits.
(f) Since August I, 1914, have you applied for a United States passport? If so, state whether application
was granted, denied or withdrawn.
No
3. State fully your participation in war service of U.S., or any of Allies or of enemy, or in that of any state militia
None
(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of examin-
ing official.
Yes. June 4th, 1918 in N. Y. City. Dr.E. Foote, U.S.N., 119 E. 40th.,
(b) Were you accepted, rejected, or is result of examination pending?
N.Y.City
Accepted by Red Cross
4. Date of birth 1886
Dec.
23
(a) Place of birth Ireland
Year
Month
Day
(b) Full name of father John Wm. Gray
(c) Birthplace of father
Ireland
(d) Nationality of father British
(e) If father foreign born, whether naturalized and when Never came to U. S.
(f) Full maiden name of mother
Annie Ruddy
(g) Birthplace of mother Ireland
(h) Nationality of mother British
(i) If mother foreign born, whether naturalized and when Never came to U. S.
(j) Full name and nationality of paternal grandfather Richard Gray, British
(k) Full maiden name and nationality of paternal grandmother Margaret Hill IT
(1) Full name and nationality of maternal grandfather William Rieddy
Sara Ardrey
(m) Full maiden name and nationality of maternal grandmother
(n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if
any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State
nature and places of employment of each of such relatives not now in such war service.
Father and mother and sisters. None.
(o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States,
specifying which ally in every case.
None
Page data
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- Source index
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- Type
- photo
- Media ID
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- Size
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Document data
- ID
- 2661552
- Core
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- Type
- document
DTO data
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"ocrText": "Form No. 200\nRevised 2-15-18\nDUPLICATE\nAMERICAN RED CROSS\nSERVICE ENROLLMENT APPLICATION\nNo.\n(OTHER THAN AS DOCTOR, SURGEON, OR NURSE)\nDate\nThe questions should be answered as fully as possible, especially when an application for a passport may later_be necessary.\nAll answers must be in handwriting of applicant.\nI. Name in full Sara M. Gray\nTelephone No. Intervale 575\nPresent\nAddress c/o Mrs. Snedden, 1564 Crotona Park; E. Br onx, N. Y. City, N.Y.\n2.\n(Number and Street)\n(City)\n(State)\n(a) If any changes of residence since August I, 1914, give these in full with dates.\nHosp.\nto\nJen.\nN. Y. S. &C. Hosp., Aug, 1, 14 to Aug. 16. Union Hosp Bronx to Jen. '14\nPresent add. since\n(b) What is your present business or profession? (Be specific.)\nPrivate Nursing\n(c) What previous business or professional experience have you had, stating nature, places and principal dates\nthereof?\nWorked as undergraduate of practical nurse in Unic on Hosp.\n2456 Valentine Ave., Bronx.\n(d) Have you ever lived in Europe? If so, give names of European countries in which you have resided\nand respective dates of residence in each.\nYes. Ireland from birth until 21 years old\n(e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits.\n(f) Since August I, 1914, have you applied for a United States passport? If so, state whether application\nwas granted, denied or withdrawn.\nNo\n3. State fully your participation in war service of U.S., or any of Allies or of enemy, or in that of any state militia\nNone\n(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of examin-\ning official.\nYes. June 4th, 1918 in N. Y. City. Dr.E. Foote, U.S.N., 119 E. 40th.,\n(b) Were you accepted, rejected, or is result of examination pending?\nN.Y.City\nAccepted by Red Cross\n4. Date of birth 1886\nDec.\n23\n(a) Place of birth Ireland\nYear\nMonth\nDay\n(b) Full name of father John Wm. Gray\n(c) Birthplace of father\nIreland\n(d) Nationality of father British\n(e) If father foreign born, whether naturalized and when Never came to U. S.\n(f) Full maiden name of mother\nAnnie Ruddy\n(g) Birthplace of mother Ireland\n(h) Nationality of mother British\n(i) If mother foreign born, whether naturalized and when Never came to U. S.\n(j) Full name and nationality of paternal grandfather Richard Gray, British\n(k) Full maiden name and nationality of paternal grandmother Margaret Hill IT\n(1) Full name and nationality of maternal grandfather William Rieddy\nSara Ardrey\n(m) Full maiden name and nationality of maternal grandmother\n(n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if\nany, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State\nnature and places of employment of each of such relatives not now in such war service.\nFather and mother and sisters. None.\n(o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States,\nspecifying which ally in every case.\nNone"
}