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NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
ROBERT w. DE FOREST, VICE PRESIDENT
MRS. AUGUST BELMONT
CALVIN COOLIDGE, VICE PRESIDENT
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
MABEL T. BOARDMAN
CHARLES EVANS HUGHES. VICE PRESIDENT
JOSEPH P. COTTON
THOMAS D. THACHER, COUNSELOR
MIDWESTERN BRANCH
MRS. HENRY P. DAVISON
OGDEN L. MILLS, TREASURER
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN, SECRETARY
1709 WASHINGTON AVE.
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
ST. LOUIS, MO.
OGDEN L. MILLS
NATIONAL EXECUTIVE OFFICERS
GUSTAVUS D. POPE
MRS. HENRY R. REA
JOHN BARTON PAYNE, CHAIRMAN
WM. M. BAXTER, JR.
REAR ADMIRAL CHARLES E. RIGGS
JOHN D. RYAN
JAMES L. FIESER, Vice CHAIRMAN
ERNEST P. BICKNELL, VICE CHAIRMAN
ASSISTANT TO TRE vice CHAIRMAN
GEORGE E. SCOTT
HENRY UPSON SIMS
JAMES K. Meclintock. Vicis CHAIRMAN
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 Furses enrolled with our Committee, with their
latest addresses. We are extremely andious te make a very complete report to Nation
al Headquarters and ask for your ceoperation. Please enswer the following questions
and return this form to me, in enclosed envelege, at the earliest possible date.
Yours singemely,
IMPORTANT:
Chairman or
Sarah E.Zeller
In order to render prompt ser-
Secretary
vice in time of disaster, enrelled
Topeka Kansas
Red Cross nurses should report at
Local Committee.
once to the Secretary of the Local
635 Fillmore St.
Committee under which they are en-
rolled. Do not forget the address
of the-Secretary.
Name in full
Pylin
Age
If married, give husband's name
Permanent address (Street, etc.) (City) Kausas (state)
Address for the next year
alion
(Street, etc.)
Telephone No. 389-X
(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)
sister many Chaning St. Kausas
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U. S. Vet. Hospital
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?
Have you ever been?
Indicate present physicel condition
good
Would to an call in event of digaster, war, etc. ?.
you respond emergency epidemic, (neceing
Badge No. 255-09
Current date Feb.
2
NOTE - If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrollment will be annulled.
5
Form 1045.
5
D=653
0
1881---FIFTY YEARS OF SERVICE TO HUMANITY---9911
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"ocrText": "K\n0\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST, VICE PRESIDENT\nMRS. AUGUST BELMONT\nCALVIN COOLIDGE, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nCHARLES EVANS HUGHES. VICE PRESIDENT\nJOSEPH P. COTTON\nTHOMAS D. THACHER, COUNSELOR\nMIDWESTERN BRANCH\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\n1709 WASHINGTON AVE.\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nST. LOUIS, MO.\nOGDEN L. MILLS\nNATIONAL EXECUTIVE OFFICERS\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nJOHN BARTON PAYNE, CHAIRMAN\nWM. M. BAXTER, JR.\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nJAMES L. FIESER, Vice CHAIRMAN\nERNEST P. BICKNELL, VICE CHAIRMAN\nASSISTANT TO TRE vice CHAIRMAN\nGEORGE E. SCOTT\nHENRY UPSON SIMS\nJAMES K. Meclintock. Vicis CHAIRMAN\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 Furses enrolled with our Committee, with their\nlatest addresses. We are extremely andious te make a very complete report to Nation\nal Headquarters and ask for your ceoperation. Please enswer the following questions\nand return this form to me, in enclosed envelege, at the earliest possible date.\nYours singemely,\nIMPORTANT:\nChairman or\nSarah E.Zeller\nIn order to render prompt ser-\nSecretary\nvice in time of disaster, enrelled\nTopeka Kansas\nRed Cross nurses should report at\nLocal Committee.\nonce to the Secretary of the Local\n635 Fillmore St.\nCommittee under which they are en-\nrolled. Do not forget the address\nof the-Secretary.\nName in full\nPylin\nAge\nIf married, give husband's name\nPermanent address (Street, etc.) (City) Kausas (state)\nAddress for the next year\nalion\n(Street, etc.)\nTelephone No. 389-X\n(City)\n(County)\n(State)\nName and address of nearest relative or friend, in United States, through whom you\nmay be communicated with in an emergency. (State relationship)\nsister many Chaning St. Kausas\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U. S. Vet. Hospital\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?\nHave you ever been?\nIndicate present physicel condition\ngood\nWould to an call in event of digaster, war, etc. ?.\nyou respond emergency epidemic, (neceing\nBadge No. 255-09\nCurrent date Feb.\n2\nNOTE - If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled.\n5\nForm 1045.\n5\nD=653\n0\n1881---FIFTY YEARS OF SERVICE TO HUMANITY---9911"
}