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OCT 12 1945
RED CROSS BADGE NUMBER (?)Badger papers
AMERICAN RED CROSS
anim trunk between Honoludu
NURSING SERVICES
MILITARY SERIAL NUMBER
ANNUAL QUESTIONNAIRE - 1945
CHECK IF YOUR LAST NAME HAS CHANGED
NAME (Last, first, middle)
TELEPHONE NO.
Grobouski, marian Gilson
IF MARRIED, GIVE MAIDEN NAME
HUSBAND'S NAME
Gilson
RERMANENT ADDRESS (Street, city, zone, county, state)
Zigmond Grobowski
M
Expect to move to city, 8378 zone, county, Greenlawn state) Ave Paims,
PRESENT ADDRESS (Street,
AND ADDRESS OF NEAREST RELATIVE OR FRIEND Falls IN THE UNITED ohio STATES
RELATIONSHIP
NAME
OF BIRTH (Month, day, Grabawski year) Single - address Married same Separated
husband
DATE
W1 idowed
Divorced
WHAT
LANGUAGES July DO YOU 9, SPEAK? 1919
YES
NO
NAME OF COLLEGE OR
English only
HIGH SCHOOL GRADUATE
DEGREE OR
C
UNIVERSITY ATTENDED
LOCATION
INCLUSIVE DATES
DIPLOMA
MAJOR
University Cincinnate Cinlinnati Chis 1937-1942 RNYBSc
Science
ARE YOU CURRENTLY
YES
NO
REGISTERED IN (State)
ARE YOU CURRENTLY A MEMBER OF THE AMERICAN
YES
NO
REGISTERED?
This y Hawaii
NURSES' ASSOCIATION?
PRESENT EMPLOYMENT If not employed, check
POSITION TITLE (H.N., P.D., inst., staff nurse, etc.)
SERVICE (Medicine, surgery, etc.)
NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED
CITY
STATE
C
HEALTH
IF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY
Good
M
VOLUNTEER SERVICE
The purpose of the following statements is to identify the nurses who can be counted upon to respond to a call
1
to participate in a Red Cross chapter program. Please check the "Yes" box only if you are willing and able to
serve if called on within the next 12 mon ths.
NAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS
1. Teach home
YES
NO
Attend an instructors' training program, if offered. (Funds are available for
YES
NO
nursing classes
training home nursing instructors. See local chapter.)
YES
NO
only in home community
Attend disaster institutes, if
YES
NO
2. Serve in case
of disaster
In other communities
offered, in preparation for service
3. Teach nurse's
YES
NO
4. Accept membership on chapter cóm-
YES
NO
5. Assist with other chapter
YES
NO
aide classes
mittee should services be needed
programs, as needed
If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that
YES
NO
you will be able to serve at some time in the future?
Unable DATE to SERVE, sure at persent because SIGNATURE in feores morning
IF UNABLE TO GIVE MAJOR REASONS-
10-10-45
Marian Giobowaki
YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHFOLNESS IN
KEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE
COMMITTEE NAMED BELOW.
ATTENTION
Fill in committee name Mrs. Edna B. Thornell, Secretary to nurse. C
SECRETARY
Cincinnati & Hamilton Co. Chapter
NURSE RECRUITMENT
American Red Cross
11/29/yJ
COMMITTEE
2343 Auburn Avenue
78504M
Cincinnati 19, Ohio
FORM 1045 Rev. July 1945
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"ocrText": "OCT 12 1945\nRED CROSS BADGE NUMBER (?)Badger papers\nAMERICAN RED CROSS\nanim trunk between Honoludu\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nNAME (Last, first, middle)\nTELEPHONE NO.\nGrobouski, marian Gilson\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nGilson\nRERMANENT ADDRESS (Street, city, zone, county, state)\nZigmond Grobowski\nM\nExpect to move to city, 8378 zone, county, Greenlawn state) Ave Paims,\nPRESENT ADDRESS (Street,\nAND ADDRESS OF NEAREST RELATIVE OR FRIEND Falls IN THE UNITED ohio STATES\nRELATIONSHIP\nNAME\nOF BIRTH (Month, day, Grabawski year) Single - address Married same Separated\nhusband\nDATE\nW1 idowed\nDivorced\nWHAT\nLANGUAGES July DO YOU 9, SPEAK? 1919\nYES\nNO\nNAME OF COLLEGE OR\nEnglish only\nHIGH SCHOOL GRADUATE\nDEGREE OR\nC\nUNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nUniversity Cincinnate Cinlinnati Chis 1937-1942 RNYBSc\nScience\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nThis y Hawaii\nNURSES' ASSOCIATION?\nPRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.)\nSERVICE (Medicine, surgery, etc.)\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nCITY\nSTATE\nC\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\nGood\nM\nVOLUNTEER SERVICE\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to a call\n1\nto participate in a Red Cross chapter program. Please check the \"Yes\" box only if you are willing and able to\nserve if called on within the next 12 mon ths.\nNAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\n1. Teach home\nYES\nNO\nAttend an instructors' training program, if offered. (Funds are available for\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\nYES\nNO\nonly in home community\nAttend disaster institutes, if\nYES\nNO\n2. Serve in case\nof disaster\nIn other communities\noffered, in preparation for service\n3. Teach nurse's\nYES\nNO\n4. Accept membership on chapter cóm-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\naide classes\nmittee should services be needed\nprograms, as needed\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that\nYES\nNO\nyou will be able to serve at some time in the future?\nUnable DATE to SERVE, sure at persent because SIGNATURE in feores morning\nIF UNABLE TO GIVE MAJOR REASONS-\n10-10-45\nMarian Giobowaki\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHFOLNESS IN\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE\nCOMMITTEE NAMED BELOW.\nATTENTION\nFill in committee name Mrs. Edna B. Thornell, Secretary to nurse. C\nSECRETARY\nCincinnati & Hamilton Co. Chapter\nNURSE RECRUITMENT\nAmerican Red Cross\n11/29/yJ\nCOMMITTEE\n2343 Auburn Avenue\n78504M\nCincinnati 19, Ohio\nFORM 1045 Rev. July 1945"
}