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No. 1
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
anna gr. Kirr R M.
I. Name of applicant
2. Address in full
1860 426 hast 26; it I for City
3. Date of birth
Place of birth
might
Mundaugh h I
4. Are you married, single, or a widow?
5. Are you a citizen of the United States?
gifts
6. Have you any physical defects?
7. Education and occupation before entering Training School
Educated at provide
school m h.y
8. From what Training
Tohnal
School did you graduate? Billions Hospital Iraining
9. Character of hospital : General?
Special?.
Private?
IO. How many beds in hospital at time of graduation?
83.D.
II. Date of graduation 1892
Length of course
2 years
12. Name and address of Superintendent of Training School under whom you were trained
muss h. I. Brennan I & 4 fity
I3. Of what nursing organization are you a member?
Billione Wummer assum
IM 14. you live name and septe address of 3th Secretary Tohanlo hires Reading 426 G. 26, it
I5. Are you a registered nurse? grs In what State? Date of
registration
-
16. How and where have you been employed since graduation? Give information for each year
Tust my Idenal muses, Walth Dept n y. City
Prinate mussing Ismit Supt Belling In Lebsal
17. Name and permanent address of nearest relative
Date Tip. 19.2 1911
Signature
Anna n ther R In
This blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded
with credentials" (Form Nos. 3 and 4), to the Chairman National Committee on Red Gross Nursing Service, Washington, D. C.
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"ocrText": "No. 1\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nanna gr. Kirr R M.\nI. Name of applicant\n2. Address in full\n1860 426 hast 26; it I for City\n3. Date of birth\nPlace of birth\nmight\nMundaugh h I\n4. Are you married, single, or a widow?\n5. Are you a citizen of the United States?\ngifts\n6. Have you any physical defects?\n7. Education and occupation before entering Training School\nEducated at provide\nschool m h.y\n8. From what Training\nTohnal\nSchool did you graduate? Billions Hospital Iraining\n9. Character of hospital : General?\nSpecial?.\nPrivate?\nIO. How many beds in hospital at time of graduation?\n83.D.\nII. Date of graduation 1892\nLength of course\n2 years\n12. Name and address of Superintendent of Training School under whom you were trained\nmuss h. I. Brennan I & 4 fity\nI3. Of what nursing organization are you a member?\nBillione Wummer assum\nIM 14. you live name and septe address of 3th Secretary Tohanlo hires Reading 426 G. 26, it\nI5. Are you a registered nurse? grs In what State? Date of\nregistration\n-\n16. How and where have you been employed since graduation? Give information for each year\nTust my Idenal muses, Walth Dept n y. City\nPrinate mussing Ismit Supt Belling In Lebsal\n17. Name and permanent address of nearest relative\nDate Tip. 19.2 1911\nSignature\nAnna n ther R In\nThis blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded\nwith credentials\" (Form Nos. 3 and 4), to the Chairman National Committee on Red Gross Nursing Service, Washington, D. C."
}