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QUINTUPLICATE
Form No. 200
Revised 5-15-18
AMERICAN RED CROSS
SERVICE APPLICATION FORM
Applicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus
of the American Red Cross.
These questions must be answered fully or the application will not be acted upon.
Date
July 26, 1918.
I. Name in full
Caroline Anelia Kidd
Telephone No
489-II
2. Permanent Address
1011 (Number and
Marletta
Ohiolate
3. Temporary Address, if any, to what date
(Number and Street)
(City)
(State)
4. (a) If any changes of residence since August I, 1914, give these in full with dates
Caring for my mother
some mos.at Stanleyville, Oup cand to Marietta again in Jen.1910.
(b) What is your present business or profession?
Nursing
Name of firm or corporation with which associated
Duration of Service
Present Capacity.
Business Address
(Number and Street)
(City)
(State)
5. Date of Birth 1873
(a) Place of birth
(Year)
(Month)
(Day)
Stanleyville, Ohio
(b) If of foreign birth, when and where did you arrive in the United States?
6. If foreign born, give date and court of your naturalization
7. (a) Single, married or widower
single
(a) Number of Dependents
(b) Full name of wife before marriage; or husband
None
(c) Birthplace of wife or husband
Nationality of wife or husband
(d) Birthplace and nationality of father of wife or husband
(e) Birthplace and nationality of mother of wife or husband
(f) Full name of father
Mathenial Evena Hild
(g) Birthplace and nationality of father
Washington Coe, Ohio - Purely American
(h) If father foreign born, whether naturalized, when and where.
English doscent
(2) Full maiden name of mother Heriette Adaline Beretow
(j) Birthplace and nationality of mother
Washington Co., Ohio
American several generations back
(k) If mother foreign born, whether naturalized, when and where
(1) Full name and nationality of paternal grandfather
Nathaniel Kind
American, English descent
(m) Full maiden name and nationality of paternal grandmother.
Mary HILL - American English descent
(n) Full name and nationality of maternal grandfather.
Henry Barstow - American
English se for as I know
(o) Full maiden name and nationality of maternal grandmother
Caroline Amelia Woodward
English descent - American born
8. (a) What previous business or professional experience have you had, stating nature, places and principal dates
thereof; the names of the firms or corporations with which you were associated
School teacher from 1892 until 1901 Countary teacher in Washington Co., Ohio
Page data
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- Source index
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- Type
- photo
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Document data
- ID
- 2661753
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "QUINTUPLICATE\nForm No. 200\nRevised 5-15-18\nAMERICAN RED CROSS\nSERVICE APPLICATION FORM\nApplicants for Nursing and Medical Service must accompany this form with special forms supplied by the Nursing Service and the Medical Service Bureaus\nof the American Red Cross.\nThese questions must be answered fully or the application will not be acted upon.\nDate\nJuly 26, 1918.\nI. Name in full\nCaroline Anelia Kidd\nTelephone No\n489-II\n2. Permanent Address\n1011 (Number and\nMarletta\nOhiolate\n3. Temporary Address, if any, to what date\n(Number and Street)\n(City)\n(State)\n4. (a) If any changes of residence since August I, 1914, give these in full with dates\nCaring for my mother\nsome mos.at Stanleyville, Oup cand to Marietta again in Jen.1910.\n(b) What is your present business or profession?\nNursing\nName of firm or corporation with which associated\nDuration of Service\nPresent Capacity.\nBusiness Address\n(Number and Street)\n(City)\n(State)\n5. Date of Birth 1873\n(a) Place of birth\n(Year)\n(Month)\n(Day)\nStanleyville, Ohio\n(b) If of foreign birth, when and where did you arrive in the United States?\n6. If foreign born, give date and court of your naturalization\n7. (a) Single, married or widower\nsingle\n(a) Number of Dependents\n(b) Full name of wife before marriage; or husband\nNone\n(c) Birthplace of wife or husband\nNationality of wife or husband\n(d) Birthplace and nationality of father of wife or husband\n(e) Birthplace and nationality of mother of wife or husband\n(f) Full name of father\nMathenial Evena Hild\n(g) Birthplace and nationality of father\nWashington Coe, Ohio - Purely American\n(h) If father foreign born, whether naturalized, when and where.\nEnglish doscent\n(2) Full maiden name of mother Heriette Adaline Beretow\n(j) Birthplace and nationality of mother\nWashington Co., Ohio\nAmerican several generations back\n(k) If mother foreign born, whether naturalized, when and where\n(1) Full name and nationality of paternal grandfather\nNathaniel Kind\nAmerican, English descent\n(m) Full maiden name and nationality of paternal grandmother.\nMary HILL - American English descent\n(n) Full name and nationality of maternal grandfather.\nHenry Barstow - American\nEnglish se for as I know\n(o) Full maiden name and nationality of maternal grandmother\nCaroline Amelia Woodward\nEnglish descent - American born\n8. (a) What previous business or professional experience have you had, stating nature, places and principal dates\nthereof; the names of the firms or corporations with which you were associated\nSchool teacher from 1892 until 1901 Countary teacher in Washington Co., Ohio"
}