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DMR1 THE AMERICAN RED CROSS NURSING SERVICE Application for Enrollment (To be filled out entirely in applicant's handwriting and each question answered fully) I. Name of applicant in full Harriet Charlton Kift 2. 26 Address in full, Street 4401 market st., City Philadelphia State Pennsylvania 3. Date of birth march 24, 1892 Place of birth. sunbury ,Pennsylvania 4. Single Are you married, single or a widow? Are you a citizen of the United States? yes 5. Have you any physical defects or tendency to constitutional or pulmonary trouble? no Are you physically strong and healthy? yes 6. Name educational institutions attended before entering training school, stating number of years at each and from which you were graduated Public schools of Sunbury graduated from Sumbury High N chool 7. What languages other than English do you speak? none 8. Occupation before entering training school 5 chool 9. From what hospital training school did you receive your diploma? children's Hospital of Philadelphia City and state Philadelphia, Pennsy waive Date of graduation Feb. it 1914 IO. Character of hospital: General? yes Special? Private? II. Did your training include obstetrics? no Care of men? no Children? yes Contagious diseases? yes 12. Daily average number of patients in hospital during training 100 Length of course. 2yrs. 3 mos. I3. Name and address of superintendent of training school under whom you received training Miss F.V. Ludehens atlantic city General Hospital, atlantic city, New Jersey. 14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each 15. Of what nursing organizations are you a member? alumnae association of the childrens Hospital of Philadelphia. 16. Which, if any, is affiliated with the American Nurses Association? affiliation pending 17. Give name and address of secretary of at least one of these organizations. Harriet c.kift st President-,iillian Hidlay- % Wood-Waire Phila Co, 18. Are you a registered nurse? yes In what state? Penn Date of registration 11-5-1914 Number 8091 Pas. 19. How and where employed since graduation: Give dates with months. Name and address of employers: Sixmonths change of april at.tout-1st Miss F.U. Ludekens medical and surgical 1914 atlantic city Hospital dispensaius of childrens Hospital of Phila. atlantic city n.g. One year private nursing Oct.121519-12-8-1915 f2 Three years Penns. H sp. 12-8-15 to present time Dr. Owen copp, Supt. West Phila Penn Hopital (Specify for which of the following services you wish to be considered.) Dept. for u. mental Phila nervous Pai 20. War service, wherever needed controvement or foreign When available 12-15-1918 Are you willing to take the oath of allegiance? yes 21. In tructor, Elementary Hygiene 22. Public Health Nursing Town and Country Nursing Service or for War Service 23. Name and permanent address of nearest relative Mr. Robert E. kift - father 1059 E. market St., Sunbury, Pennsylvania Date 11-3-1918 Signature of Nurse Haniet Charlton Kift To the Committee: This blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, II, and A. R. C. 150. Application forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorse- ment by Local Committee, with credentials (Forms 3 and 4), together with Forms IO and II, should be forwarded to the Chair- man, National Committee on Nursing Service, American Red Cross, Washington, D. C. In case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local Committee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Com- mittee, from whence credentials will be procured. -17-2125B-20M-Nov.

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    "ocrText": "DMR1\nTHE AMERICAN RED CROSS\nNURSING SERVICE\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully)\nI. Name of applicant in full Harriet Charlton Kift\n2.\n26\nAddress in full, Street 4401 market st., City Philadelphia State Pennsylvania\n3. Date of birth march 24, 1892\nPlace of birth. sunbury ,Pennsylvania\n4. Single\nAre you married, single or a widow?\nAre you a citizen of the United States? yes\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble? no\nAre you physically strong and healthy? yes\n6. Name educational institutions attended before entering training school, stating number of years at each and from which you\nwere\ngraduated Public schools of Sunbury graduated from\nSumbury High N chool\n7. What languages other than English do you speak? none\n8. Occupation before entering training school 5 chool\n9.\nFrom what hospital training school did you receive your diploma? children's Hospital of Philadelphia\nCity and state Philadelphia, Pennsy waive Date of graduation Feb. it 1914\nIO. Character of hospital: General? yes\nSpecial?\nPrivate?\nII.\nDid your training include obstetrics? no\nCare of men? no\nChildren? yes Contagious diseases? yes\n12. Daily average number of patients in hospital during training 100\nLength of course. 2yrs. 3 mos.\nI3. Name and address of superintendent of training school under whom you received training Miss F.V. Ludehens\natlantic city General Hospital, atlantic city, New Jersey.\n14.\nIf your training as a nurse was received in more than one hospital, give name, location and time spent in each\n15. Of what nursing organizations are you a member? alumnae association of the\nchildrens Hospital of Philadelphia.\n16. Which, if any, is affiliated with the American Nurses Association?\naffiliation pending\n17. Give name and address of secretary of at least one of these organizations. Harriet c.kift st\nPresident-,iillian Hidlay- % Wood-Waire Phila Co,\n18. Are you a registered nurse? yes In what state? Penn Date of registration 11-5-1914 Number 8091 Pas.\n19. How and where employed since graduation:\nGive dates with months.\nName and address of employers:\nSixmonths change of\napril at.tout-1st\nMiss F.U. Ludekens\nmedical and surgical\n1914\natlantic city Hospital\ndispensaius of childrens\nHospital of Phila.\natlantic city n.g.\nOne year private nursing\nOct.121519-12-8-1915\nf2 Three years Penns. H sp. 12-8-15 to present time Dr. Owen copp, Supt.\nWest Phila\nPenn Hopital\n(Specify for which of the following services you wish to be considered.)\nDept. for u. mental Phila nervous Pai\n20. War service, wherever needed controvement or foreign When available 12-15-1918\nAre you willing to take the oath of allegiance? yes\n21. In tructor, Elementary Hygiene\n22. Public Health Nursing\nTown and Country Nursing Service\nor for War Service\n23. Name and permanent address of nearest relative Mr. Robert E. kift - father\n1059 E. market St., Sunbury, Pennsylvania\nDate 11-3-1918\nSignature of Nurse Haniet Charlton Kift\nTo the Committee:\nThis blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, II, and A. R. C. 150.\nApplication forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorse-\nment by Local Committee, with credentials (Forms 3 and 4), together with Forms IO and II, should be forwarded to the Chair-\nman, National Committee on Nursing Service, American Red Cross, Washington, D. C.\nIn case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local\nCommittee, instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Com-\nmittee, from whence credentials will be procured.\n-17-2125B-20M-Nov."
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