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and FORM 1045 YH9 REV. OCT. 1943 AMERICAN RED CROSS filim ok Dear NURSING SERVICE Tagio VOTIA ANNUAL QUESTIONNAIRE-1944 SnodW oM asY avolled Red Cross If you have changed your last name 3 Badge number 9592 since contacting us, please check here. 3 Name in full Joaquim (last) Lusy (first) Louisa Tel. No Bed Vill 7141 (middle) If married, give maiden name Date of birth 45+ Marital status (single, Grried, widowed, divorced) single bus Husband's name Permanent address corner Road Bedford Westchester (county) (city) n.y. (street) state) Present address L' 11 " is (street) (city) (county) (state) 11 Notify national headquarters immediately if you change your address. betaubstO Give name and address of nearest relative or friend in the United States: Amelia (name) Joaquin Same Sister (address) (relationship) Are you employed in nursing at the present time? Yes No If employed, check the type of work you are doing and fill in below the title of your position and the name and address of the agency or institution: Institutional Public Health Industrial Private Duty Other staff nurse Heatchester Co. Dept. of Health White Plains n.y. If not employed, what type of nursing would you prefer to render ? IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX AVAILABILITY FOR SERVICE WITH THE ARMED FORCES Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40. For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She may be single or married, but if married she must have no dependents under 14 years of age. If eligible and not already in service with the armed forces, are you: Immediately available: ? Available in the near future? (specify date) Not available, for the following reason ? Over age limit (specify) Do you have any dependents under 14 years of age? Yes No AVAILABILITY FOR SERVICE WITH CIVILIANS U( If qualified and not already doing so, will you be available: ovil GHT To teach Red Cross Home Nursing classes ? no To teach volunteer nurse's aides? no To take a Red Cross emergency assignment? yes To serve overseas caring for civilians' ? no If yes, specify type of disaster World war 1 Micala smak) I Have you ever served with the Red Cross in a disaster? Yes No 5 I (siata) (vdio) N

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    "ocrText": "and\nFORM 1045\nYH9\nREV. OCT. 1943\nAMERICAN RED CROSS\nfilim\nok Dear NURSING SERVICE\nTagio\nVOTIA\nANNUAL QUESTIONNAIRE-1944\nSnodW\noM\nasY\navolled\nRed Cross\nIf you have changed your last name\n3\nBadge number 9592\nsince contacting us, please check here.\n3\nName in full Joaquim (last) Lusy (first)\nLouisa\nTel. No Bed Vill 7141\n(middle)\nIf married, give maiden name\nDate of birth 45+\nMarital status\n(single, Grried, widowed, divorced)\nsingle\nbus\nHusband's name\nPermanent address\ncorner Road Bedford Westchester (county)\n(city)\nn.y.\n(street)\nstate)\nPresent address\nL'\n11\n\"\nis\n(street)\n(city)\n(county)\n(state)\n11\nNotify national headquarters immediately if you change your address.\nbetaubstO\nGive name and address of nearest relative or friend in the United States:\nAmelia (name) Joaquin\nSame\nSister\n(address)\n(relationship)\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nstaff\nnurse\nHeatchester Co. Dept. of Health\nWhite Plains n.y.\nIf not employed, what type of nursing would you prefer to render ?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you:\nImmediately available: ?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ? Over age limit\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nU( If qualified and not already doing so, will you be available:\novil\nGHT\nTo teach Red Cross Home Nursing classes ? no\nTo teach volunteer nurse's aides?\nno\nTo take a Red Cross emergency assignment? yes\nTo serve overseas caring for civilians' ?\nno\nIf yes, specify type of disaster World war 1\nMicala smak)\nI\nHave you ever served with the Red Cross in a disaster? Yes\nNo\n5\nI\n(siata)\n(vdio)\nN"
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