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FORM 1045, REV. 7-9-32
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER. PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
CALVIN COOLIDGE, VICE PRESIDENT
THE AMERICAN RED CROSS
ARTHUR A. BALLANTINE
CHARLES EVANS HUGHES, VICE PRESIDENT
MRS. AUGUST BELMONT
THOMAS D. THACHER, COUNSELOR
CORNELIUS N. BLISS
NATIONAL HEADQUARTERS
MABEL T. BOARDMAN
ARTHUR A. BALLANTINE, TREASURER
WILLIAM R. CASTLE. JR.
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D. C.
MRS. HENRY P. DAVISON
MRS. FRANK v. HAMMAR
NATIONAL EXECUTIVE OFFICERS
1/28/35
SAMUEL KNIGHT
MAJ. GEN. ROBERT U. PATTERSON
GUSTAVUS D. POPE
JOHN BARTON PAYNE. CHAIRMAN
MRS. HENRY R. REA
JAMES L. FIESER, VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
JOHN D. RYAN
ERNEST P. BICKNELL. VICE CHAIRMAN
GEORGE E. SCOTT
JAMES K. McCLINTOCK. VICE CHAIRMAN
HENRY UPSON SIMS
THOMAS D. THACHER
ELIOT WADSWORTH
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
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in enclosed envelope, at the earliest possible date.
IMPORTANT:
Yours sincerely,
In order to render prompt service
Emma Rae mc Lead
Chairman or
in time of disaster, enrolled Red Cross
Secretary.
Nurses should report at once to the
Secretary of the Local Committee under
new Brunwweek Local Committee.
which they are enrolled. Do not forget
m.
the address of the Secretary.
Name in full Helen Ls Kerrigan
If married, give husband's name
Permanent address monmouth (STREET, ETC) an Rumsow (CITY) monmouth (COUNTY) (STATE)
Probable address for the next year
same
(STREET, ETC.)
Telephone No. 410 Rumson
(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)
miss m Q Briin monmouth are, Rumson new Jeroy
Underline the type of work you are now doing:
Army - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service -
Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?
yes
Have you ever been?
yes
Indicate present physical condition good
Would you respond to an call event war,
emergency in of epidemic, disaster, etc. ? yes.
Badge No. 730
Current date Feb 13th 1935
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. 7-9-32\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER. PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nARTHUR A. BALLANTINE\nCHARLES EVANS HUGHES, VICE PRESIDENT\nMRS. AUGUST BELMONT\nTHOMAS D. THACHER, COUNSELOR\nCORNELIUS N. BLISS\nNATIONAL HEADQUARTERS\nMABEL T. BOARDMAN\nARTHUR A. BALLANTINE, TREASURER\nWILLIAM R. CASTLE. JR.\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D. C.\nMRS. HENRY P. DAVISON\nMRS. FRANK v. HAMMAR\nNATIONAL EXECUTIVE OFFICERS\n1/28/35\nSAMUEL KNIGHT\nMAJ. GEN. ROBERT U. PATTERSON\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE. CHAIRMAN\nMRS. HENRY R. REA\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nERNEST P. BICKNELL. VICE CHAIRMAN\nGEORGE E. SCOTT\nJAMES K. McCLINTOCK. VICE CHAIRMAN\nHENRY UPSON SIMS\nTHOMAS D. THACHER\nELIOT WADSWORTH\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\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nEmma Rae mc Lead\nChairman or\nin time of disaster, enrolled Red Cross\nSecretary.\nNurses should report at once to the\nSecretary of the Local Committee under\nnew Brunwweek Local Committee.\nwhich they are enrolled. Do not forget\nm.\nthe address of the Secretary.\nName in full Helen Ls Kerrigan\nIf married, give husband's name\nPermanent address monmouth (STREET, ETC) an Rumsow (CITY) monmouth (COUNTY) (STATE)\nProbable address for the next year\nsame\n(STREET, ETC.)\nTelephone No. 410 Rumson\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)\nmiss m Q Briin monmouth are, Rumson new Jeroy\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service -\nPublic Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick?\nyes\nHave you ever been?\nyes\nIndicate present physical condition good\nWould you respond to an call event war,\nemergency in of epidemic, disaster, etc. ? yes.\nBadge No. 730\nCurrent date Feb 13th 1935\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}