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Form No. 200 Revised 2-15-18 3770 DUPLICATE. AMERICAN RED CROSS No. SERVICE ENROLLMENT APPLICATION Date (OTHER THAN AS DOCTOR, SURGEON, OR NURSE) The questions should be answered as fully as possible, especially when an application for a passport may later be necessary. HOAGLAND. ha of applicant, West 4960 I. Name in full 618-8.Spaulding Chicagelephone No Illinots. 2. Present Address (Number and Street) (City) (State) (a) If any 3036 of 154 sith 1916,3302 Flourney St. 1917 (b) What hicago. (c) What previous business or professional experience have you had, stating nature, places and principal datesIthersof Training School for Nurses Aug. 185,1908 to Sept.8,1911 Head- Nurse, Mens Surgical Ward; Sept.8-Mar 1/10. Supervisor Rooms Glenville Bosp. Cleveland, 0. Jun 1912-Aug.1,1914.Supervisor of Ear, Nose and Throat Dept. Cook Co. Hosp. Sept. 1/14 to June 1/15. (d) Have you ever lived in Europe? If so, give hametor Eutopean Ccoukt iesDie Hwhich youne date and respective dates of residence in each. (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 If so, state whether application wasggranted, denied or withdrawn. 3.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. H - (a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex- amining official. (b) Were you accepted, rejected, or is result of examination pending? 1884 June 1st Logansport, Ind. 4. Date of birth (a) Place of birth Year Edward Moagland, (b) Full name of father New York State American (c) Birthplace of father (d) Natioriality of father (e) If father foreign born, whether dhfsonlaugh, (f) Full maiden name of mothridiana (g) Birthplace of mother (h) Nationality of mother (i) If mother foreign born, whether naturalized and when Abraham Koagland, ,American (j) Full name and nationality of paternal grandfather Cornelia VanBuskirk, American (k) Full maiden name and nationality of paternal grandmother John II Johnsonlaugh, Americar (1) Full name and nationality of maternal grand father (m) Full maiden name and nationality of maternal grandmother Sarah Shafer,American (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. 3 (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.

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Page context
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    "ocrText": "Form No. 200\nRevised 2-15-18\n3770\nDUPLICATE.\nAMERICAN RED CROSS\nNo.\nSERVICE ENROLLMENT APPLICATION\nDate\n(OTHER THAN AS DOCTOR, SURGEON, OR NURSE)\nThe questions should be answered as fully as possible, especially when an application for a passport may later be necessary.\nHOAGLAND. ha of applicant,\nWest 4960\nI. Name in full\n618-8.Spaulding\nChicagelephone No\nIllinots.\n2. Present Address\n(Number and Street)\n(City)\n(State)\n(a) If any 3036 of 154 sith 1916,3302\nFlourney St. 1917\n(b) What hicago.\n(c) What previous business or professional experience have you had, stating nature, places and principal\ndatesIthersof Training School for Nurses Aug. 185,1908 to Sept.8,1911\nHead- Nurse, Mens Surgical Ward; Sept.8-Mar 1/10. Supervisor\nRooms Glenville Bosp. Cleveland, 0. Jun 1912-Aug.1,1914.Supervisor\nof Ear, Nose and Throat Dept. Cook Co. Hosp. Sept. 1/14 to June 1/15.\n(d) Have you ever lived in Europe? If so, give hametor Eutopean Ccoukt iesDie Hwhich youne date\nand respective dates of residence in each.\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\nwasggranted, denied or withdrawn.\n3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state\nmilitia.\nH\n-\n(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex-\namining official.\n(b) Were you accepted, rejected, or is result of examination pending?\n1884\nJune\n1st\nLogansport, Ind.\n4. Date of birth\n(a) Place of birth\nYear\nEdward Moagland,\n(b) Full name of father\nNew York State\nAmerican\n(c) Birthplace of father\n(d) Natioriality of father\n(e) If father foreign born, whether dhfsonlaugh,\n(f) Full maiden name of mothridiana\n(g) Birthplace of mother\n(h) Nationality of mother\n(i) If mother foreign born, whether naturalized and when\nAbraham Koagland, ,American\n(j)\nFull name and nationality of paternal grandfather\nCornelia VanBuskirk, American\n(k) Full maiden name and nationality of paternal grandmother\nJohn\nII\nJohnsonlaugh, Americar\n(1) Full name and nationality of maternal grand father\n(m) Full maiden name and nationality of maternal grandmother\nSarah Shafer,American\n(n)\nNames of all relatives nearer than second cousins living in Europe, specifying which of said relatives,\nif any, 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.\n3\n(o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United\nStates, specifying which ally in every case."
}