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FORM 1045--REV. 2-24-27
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
ROBERT w. DE FOREST. VICE PRESIDENT
MRS. AUGUST BELMONT
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
MABEL T. BOARDMAN
WILLIAM D. MITCHELL, COUNSELOR
MRS. MENRY P. DAVISON
OGDEN L. MILLS, TREASURER
NATIONAL HEADQUARTERS
E.B. DOUGLAS
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D.C.
HERBERT HOOVER
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
WILLIAM D. MITCHELL
JOHN BARTON PAYNE, CHAIRMAN
ROBERT E, OLDS
JAMES L. FIESER, VICE CHAIRMAN
GUSTAVUS D. POPE
ERNEST P. BICKNELL. VICE CHAIRMAN
MRS. HENRY R. REA
JAN 1 1929
JOHN D. RYAN
GEORGE E, SCOTT
REAR ADMIRAL E. R. STITT
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
e
Headquarters and ask for your cooperation. Please answer the following questions and
lo
return this form to me, in the enclosed envelope, at the earliest possible date.
-
IMPORTANT:
Yours sincerely,
er
AGNES J. HEA, R. N.
T
In order to render prompt service
Chairman or
in time of disaster, enrolled Red Cross
SEC'Y OF BOSTON LOCAL COMMITTEE
Secretary.
nurses should report at once to the
RED CROSS NURSING SERVICE
Secretary of the Local Committee under
346 BELGRADE AVE.
Local Committee.
which they are enrolled. Do not forget
WEST ROXBURY; MASS,
the address of the Secretary.
Name in full
Kattannie Wheeler stolmes
If married, give husband's name
Permanent address Brushwood Farm Pond LT Franklin, Mass.
Probable address for the next year Same
Telephone No. 394-W
Name and address of nearest rolative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Elizabets L. Holmes (rister) 115 Sharneliffe R'd, Newton, llass
Underline the type of work
you are now doing: - Army - Navy U.S.P.H. Hospital U.S.Vet. Hospital - Public
Health Institutional Private Duty Industrial Office Nurse Registral Farming
- - - - -
1
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No
Have you ever been?
No
Indicate present physical condition Fair - S wae chemistiam
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Badge No. 16590
Ifatholutely mensary -
Current date
Jack 7.1929
NOTE.-If -- the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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"ocrText": "FORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nCALVIN COOLIDGE, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL, COUNSELOR\nMRS. MENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nE.B. DOUGLAS\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nHERBERT HOOVER\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nWILLIAM D. MITCHELL\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT E, OLDS\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\nERNEST P. BICKNELL. VICE CHAIRMAN\nMRS. HENRY R. REA\nJAN 1 1929\nJOHN D. RYAN\nGEORGE E, SCOTT\nREAR ADMIRAL E. R. STITT\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\ne\nHeadquarters and ask for your cooperation. Please answer the following questions and\nlo\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\n-\nIMPORTANT:\nYours sincerely,\ner\nAGNES J. HEA, R. N.\nT\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nSEC'Y OF BOSTON LOCAL COMMITTEE\nSecretary.\nnurses should report at once to the\nRED CROSS NURSING SERVICE\nSecretary of the Local Committee under\n346 BELGRADE AVE.\nLocal Committee.\nwhich they are enrolled. Do not forget\nWEST ROXBURY; MASS,\nthe address of the Secretary.\nName in full\nKattannie Wheeler stolmes\nIf married, give husband's name\nPermanent address Brushwood Farm Pond LT Franklin, Mass.\nProbable address for the next year Same\nTelephone No. 394-W\nName and address of nearest rolative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nElizabets L. Holmes (rister) 115 Sharneliffe R'd, Newton, llass\nUnderline the type of work\nyou are now doing: - Army - Navy U.S.P.H. Hospital U.S.Vet. Hospital - Public\nHealth Institutional Private Duty Industrial Office Nurse Registral Farming\n- - - - -\n1\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No\nHave you ever been?\nNo\nIndicate present physical condition Fair - S wae chemistiam\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 16590\nIfatholutely mensary -\nCurrent date\nJack 7.1929\nNOTE.-If -- the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}