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I 5 (6 Top Sheet Y Upper portion for Bivisional Record. Also see last portion of application Mys form. + Recommended by Central Division for enrollment under Requisition to If not American citizen, so state, and give citizenship Is applicant available leaving home two weeks from date full papers are rec'd in Washington N Name Hines, Myrtle Nellie Street Address R. F. D. #4 e Jane McAlister Hospital, = City Frederick, Md. Temporary Address to what date Waukegan, Ill. Please check or fill out blanks where possible. e Janguages spoken Location of Proposed length of stay 1 year or more. E-Excellent Service desired Full Volunteer No G-Good F-Fair Volunteer with expenses met by Red Cross Yes. Is allowance for living abroad to be left to discretion of foreign Commission? Allowance for living abroad if not left to discretion of foreign Commission? salary over expense allowance if any $60.00 monyh. Allowance for living prior to departure: $4.00 day Requisition for uniform and equipment Yes. Allowance for transportation overseas and re- turn Yes. Allowance for transportation in U.S.and return Yes. Physical Report Age 31 Loyalty investigation conducted by (Name of agency Date examined Date Reported employed, if any) and Report central Division. o. K. O. K. List of Loyalty indorsements: Have passport application and pictures been forwarded Date Headquarters Record (Initial, date, and "o.K." where acceptable) File Record Date Referred to Classification Full papers Provisional Enrollment War Dept. 7/31'18 2 Physical Actual Enrollment W Remarks 8 6

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Core
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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\n5\n(6\nTop Sheet\nY\nUpper portion for Bivisional Record. Also see last portion of application\nMys\nform.\n+\nRecommended by Central Division for enrollment under Requisition\nto\nIf not American citizen, so state, and give citizenship\nIs applicant available leaving home two weeks from date full papers are rec'd in\nWashington\nN\nName\nHines, Myrtle Nellie\nStreet Address R. F. D. #4\ne\nJane McAlister Hospital,\n=\nCity\nFrederick, Md.\nTemporary Address to what date Waukegan, Ill.\nPlease check or fill out blanks where possible.\ne\nJanguages spoken\nLocation of\nProposed length of stay 1 year or more.\nE-Excellent\nService desired\nFull Volunteer\nNo\nG-Good F-Fair\nVolunteer with expenses met by Red Cross Yes.\nIs allowance for living abroad to be left to\ndiscretion of foreign Commission?\nAllowance for living abroad if not left to\ndiscretion of foreign Commission?\nsalary over expense allowance if any $60.00 monyh.\nAllowance for living prior to departure: $4.00 day\nRequisition for uniform and equipment Yes.\nAllowance for transportation overseas and re-\nturn Yes.\nAllowance for transportation in U.S.and return\nYes.\nPhysical Report\nAge 31\nLoyalty investigation conducted by (Name of agency\nDate examined\nDate Reported\nemployed, if any)\nand Report\ncentral Division.\no. K.\nO. K.\nList of Loyalty indorsements:\nHave passport application and pictures been forwarded\nDate\nHeadquarters Record (Initial, date, and \"o.K.\" where acceptable)\nFile Record\nDate\nReferred to\nClassification\nFull papers\nProvisional Enrollment\nWar Dept. 7/31'18\n2\nPhysical\nActual Enrollment\nW\nRemarks\n8\n6"
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