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I No. 1 RECEIVED AMERICAN RED CROSS FEB-31912 NURSING SERVICE c. APPLICATION FOR ENROLLMENT + (To be filled out entirely in applicant's handwriting) + I. Name of applicant mis) Helen death Star 2. Address in full now 509 Honorish Chicago after of 1-12-464 E 13 3. Date of birth Junway Place of birth Lane Calif 4. Are or a widow ? you married, single, Single 5. Are you a citizen of the United States ? yes no 6. Have you any physical defects? (see) z. Education and occupation before entering Training School Grad. Savanne Sade BLAndhuraterm him 93, 3 titus attanio jhings 1900 8. From did what Training School you graduate? Illinois Draining thool for muss Chicago 9. Character of hospital General atlook Co Special? Private IO. How many beds in hospital at time of graduation? 900 approp II. graduation 1895 Date of Length of course 2yrs 12. Name and address of Superintendent of Training School under whom you were trained mind .L.Dock Systteville Pa Miss Missan Bentin Habri 13. Of what nursing organization are you a member lile State leopies Grad Misse, smich 3 alumnal bosu I 5.5.6 2 Agrenian Sriet suppt nurse, 15. Are you a registered nurse? yes In what State? see 14. Give name and address of Secretary usmiss WE Backe 4703 magnolia Chicago are Date of registration 1909 mise 16. How and State where Anto have you to begn modie employed Claguda since graduation da. B Give 96-98 information Spiwa for each te year Sanita 9596Head data to his main 99- the Blaccbroo 2.1.190x pirate - dutching duty supporting councilated Cal' Country savel High School sure to Name permanent time [relative 06-111 Ill mischool Cell gospinate decide 19047-06 and address of nearest (State) Mrs anua H. Johnston 464 Paradlun Cel Date. 10-28-11 Signature Halen Scott stay, R. n. U Lelephone West 214 This blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded C with credentials' (Form Nos. 3 and 4), to the Chairman National Gommittee on Red Cross Nursing Service, Washington, D. C. 8 10fts 2

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184
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0
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unknown

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Document identity
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Document source extras
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Page context
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    "ocrText": "I\nNo. 1\nRECEIVED\nAMERICAN RED CROSS\nFEB-31912\nNURSING SERVICE\nc.\nAPPLICATION FOR ENROLLMENT\n+\n(To be filled out entirely in applicant's handwriting)\n+\nI. Name of applicant mis) Helen death Star\n2. Address in full now 509 Honorish Chicago after of 1-12-464 E\n13 3. Date of birth Junway Place of birth Lane Calif\n4. Are or a widow ?\nyou married, single, Single\n5. Are you a citizen of the United States ? yes no\n6. Have you any physical defects?\n(see)\nz. Education and occupation before entering Training School Grad. Savanne Sade\nBLAndhuraterm him 93,\n3 titus attanio jhings 1900\n8. From did\nwhat Training School you graduate? Illinois Draining thool\nfor muss Chicago\n9.\nCharacter of hospital General atlook Co Special?\nPrivate\nIO.\nHow many beds in hospital at time of graduation? 900 approp\nII. graduation 1895\nDate of\nLength of course 2yrs\n12. Name and address of Superintendent of Training School under whom you were trained\nmind .L.Dock Systteville Pa Miss Missan Bentin Habri\n13.\nOf what nursing organization are you a member lile State leopies Grad Misse, smich\n3 alumnal bosu I 5.5.6\n2 Agrenian Sriet suppt nurse,\n15. Are you a registered nurse? yes In what State? see\n14. Give name and address of Secretary usmiss WE Backe 4703 magnolia Chicago are\nDate of registration 1909\nmise 16. How and State where Anto have you to begn modie employed Claguda since graduation da. B Give 96-98 information Spiwa for each te year Sanita 9596Head\ndata to his main 99-\nthe Blaccbroo 2.1.190x pirate - dutching duty supporting councilated Cal' Country\nsavel High School\nsure to Name permanent time [relative 06-111 Ill mischool\nCell gospinate decide 19047-06\nand address of nearest\n(State) Mrs anua H. Johnston 464 Paradlun Cel\nDate. 10-28-11\nSignature Halen Scott stay, R. n.\nU\nLelephone West 214\nThis blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded\nC\nwith\ncredentials' (Form Nos. 3 and 4), to the Chairman National Gommittee on Red Cross Nursing Service, Washington, D. C.\n8\n10fts\n2"
}