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AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
I. Name of applicant alice Evangeline Lake. R.n.
Address in full 325 East 18th Cur. Wenver, Colo.
2.
30
3. Date of birth Des. 14-1880 Place of birth golden, Colo.
4. Are you married, single, or a widow?
Single
5. Are you a citizen of the United States?
yes,
6. Have you any physical defects?
no.
7. Education and occupation before entering Training School Educated in publis schwol
at golden Colo. Graduated from golden High School 1898.
8. From what Training School did you graduate?
St. Luki's Training School for nurses
9. Character of hospital : General?
yes
Special?
Private?
IO. How many beds in hospital at time of graduation?
120
II. Date of graduation June 24. - 1904 Length of course J three years,
wastrained under miss m. B. Eyes 194 2 Penn. St. Weaver.
12. Name and address of Superintendent of Training School under whom you were trained Igraduated under
Miso m. Bullene- 2.2.21 Druning ave- Wenver, Colo-
I3. Of what nursing organization are you a member? Colo. State Trained nurses- assin.
[st. Lulie nurses Alumnal is eligible to nurses associated alumnae + pending
14. Give name and address of Secretary miss Louise Perrin- 4303 Clay St. Denver-Colo
15. Are you a registered nurse? yeo- In what State? Colorado Date of registration Oct. 1905.
16. How and where have you been employed since graduation? Give information for each year 1904. + 1906
Private nursingwith six mouthsas Supt. of Deswer Women's Heapo (substituting)
room at S.t. Luke's topp to June 1911 private mirsin g- at greenest
1906-1908 - Private nursing is Denver - wes. 1908 to Oct. 1909 in charge of Operating
substituting 17. Name and H read permanent nurse address Children's of nearest relative Hoop. enroll Colo-
C. w. Lake - golden, Colo- (father)
Date July 2-19.11
Signature
a. E. Lake a.h.
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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Document data
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- Core
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"ocrText": "No\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nI. Name of applicant alice Evangeline Lake. R.n.\nAddress in full 325 East 18th Cur. Wenver, Colo.\n2.\n30\n3. Date of birth Des. 14-1880 Place of birth golden, Colo.\n4. Are you married, single, or a widow?\nSingle\n5. Are you a citizen of the United States?\nyes,\n6. Have you any physical defects?\nno.\n7. Education and occupation before entering Training School Educated in publis schwol\nat golden Colo. Graduated from golden High School 1898.\n8. From what Training School did you graduate?\nSt. Luki's Training School for nurses\n9. Character of hospital : General?\nyes\nSpecial?\nPrivate?\nIO. How many beds in hospital at time of graduation?\n120\nII. Date of graduation June 24. - 1904 Length of course J three years,\nwastrained under miss m. B. Eyes 194 2 Penn. St. Weaver.\n12. Name and address of Superintendent of Training School under whom you were trained Igraduated under\nMiso m. Bullene- 2.2.21 Druning ave- Wenver, Colo-\nI3. Of what nursing organization are you a member? Colo. State Trained nurses- assin.\n[st. Lulie nurses Alumnal is eligible to nurses associated alumnae + pending\n14. Give name and address of Secretary miss Louise Perrin- 4303 Clay St. Denver-Colo\n15. Are you a registered nurse? yeo- In what State? Colorado Date of registration Oct. 1905.\n16. How and where have you been employed since graduation? Give information for each year 1904. + 1906\nPrivate nursingwith six mouthsas Supt. of Deswer Women's Heapo (substituting)\nroom at S.t. Luke's topp to June 1911 private mirsin g- at greenest\n1906-1908 - Private nursing is Denver - wes. 1908 to Oct. 1909 in charge of Operating\nsubstituting 17. Name and H read permanent nurse address Children's of nearest relative Hoop. enroll Colo-\nC. w. Lake - golden, Colo- (father)\nDate July 2-19.11\nSignature\na. E. Lake a.h.\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."
}