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FORM 1045
REV. 4-4-38
THE AMERICAN RED CROSS
D
NATIONAL HEADQUARTERS
WASHINGTON, D. C.
e
grift
Dear Red Cross Nurse:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a report of all the Red Cross Nurses enrolled with our Committee. Will you
therefore, please answer the following questions and return this form to me, in the
enclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED
WITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-
ognize the value of filing this information and will return the questionnaire promptly,
as we are extremely anxious to make a very complete report to National Headquarters.
IMPORTANT:
Yours sincerely,
In order to render prompt service
Chairman or
in time of disaster, enrolled Red Cross
Mabel Beattie
Secretary.
Nurses should report at once to the
Secretary of the Local Committee under
Kansas City, Mo.
Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Name
in full Cunday m. Hoet
If married, give husband's name
Permanent
address 20 w ETC.) 36 Kansas (CITY) City Jackson (COUNTY) mo
(STREET,
(STATE)
20 west 36
K.C. mo
Probable address for the next year
(STREET. ETC.)
Telephone No. We 8793
K.C.
no
(CITY)
(COUNTY)
(STATE)
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Mrs E. .R. Prather - Celathe Kansas
sister
Underline the type of work you are now doing:
Army - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -
Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
V.N.A.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been? no
Would you like to teach Red Cross classes?
no
Indicate condition y lood
present physical
Would you respond to an emergency call in event of epidemic, disaster, war, etc.' ? yes
Badge No.
61699
Current
date 4-5-39
NOTE. -If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be removed from our active files.
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"ocrText": "I\n0\n-\n+\nFORM 1045\nREV. 4-4-38\nTHE AMERICAN RED CROSS\nD\nNATIONAL HEADQUARTERS\nWASHINGTON, D. C.\ne\ngrift\nDear Red Cross Nurse:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a report of all the Red Cross Nurses enrolled with our Committee. Will you\ntherefore, please answer the following questions and return this form to me, in the\nenclosed envelope, at the earliest possible date? THIS ANNUAL QUESTIONNAIRE IS FILED\nWITH YOUR RECORDS AT NATIONAL HEADQUARTERS IN WASHINGTON, D. C. We hope you will rec-\nognize the value of filing this information and will return the questionnaire promptly,\nas we are extremely anxious to make a very complete report to National Headquarters.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nMabel Beattie\nSecretary.\nNurses should report at once to the\nSecretary of the Local Committee under\nKansas City, Mo.\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName\nin full Cunday m. Hoet\nIf married, give husband's name\nPermanent\naddress 20 w ETC.) 36 Kansas (CITY) City Jackson (COUNTY) mo\n(STREET,\n(STATE)\n20 west 36\nK.C. mo\nProbable address for the next year\n(STREET. ETC.)\nTelephone No. We 8793\nK.C.\nno\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nMrs E. .R. Prather - Celathe Kansas\nsister\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - Veterans Administration - U.S. Indian Service -\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nV.N.A.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? no\nWould you like to teach Red Cross classes?\nno\nIndicate condition y lood\npresent physical\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.' ? yes\nBadge No.\n61699\nCurrent\ndate 4-5-39\nNOTE. -If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be removed from our active files."
}