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6.
Check all degrees obtained subsequent to entering training:
Bachelor's Degree
Master's Degree
Certificate in Public Health Nursing
7. In which major field was your academic study?
Institutional
Public Health
Other (specify)
Non-nursing (specify)
Courses in principles of teaching
Courses in practice teaching (type)
State teacher's certificate?
Where?
Foreign languages spoken
IV. EXPERIENCE
Hospital or Organization
City and State
Nature of Work
Dates
Person in Charge
Visiting Nurse Association
Chicago, Ill.
Staff Nurse
1909-12
Miss Edna Foley
"
"
"
Supervisor
1912-18
11
"
11
Metropolitan Life Ins. Co.
New York City
Territorial Supr. 1918-21
Dr. Lee K. Frankel
"
If
"
"
"
"
Supt. of Nursing 1921-40
Dr.W.P.Shepard
For teaching experience indicate: elementary, secondary, normal, college, nursing, or other.
Have you taught Red Cross Home Nursing (formerly Home Hygiene and Care of the Sick)?
Chapter
City and State
Type Groups
Dates
V. EMPLOYMENT BASIS
1. Type of work preferred: Rural
Urban
Will you accept either? Yes
2. What State or localities do you prefer? Middle West Territory
3. When will you be available? after Oct. 19, 1942.
4. Can you drive a car?
yes
Do you own a car? No
5. What dependents or family responsibilities do you have?
None
6. Name of nearest relative to be notified in case of accident (relationship and address)
Mrs. Thomas Coughlan, 7962 Phillips Ave., Chicago, Illinois - daughter.
7. Give name of placement service, if registered with one
8. May we approach your present employer for references?
Yes
9. Do you have good health?
Yes
10. When did you have your last physical examination? January, 1941
Remarks: no available pholograph
(Please attach photograph
of yourself, taken within
the past two years. )
Helen La Malle
(Signature of applicant)
Date Oct 19, 1942
Page data
- Page
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- Source index
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- Type
- photo
- Media ID
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- Size
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Document data
- ID
- 2661789
- Core
- doc
- Type
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DTO data
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Context sent to Scholar
Document identity
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Document source extras
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Page context
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"ocrText": "6.\nCheck all degrees obtained subsequent to entering training:\nBachelor's Degree\nMaster's Degree\nCertificate in Public Health Nursing\n7. In which major field was your academic study?\nInstitutional\nPublic Health\nOther (specify)\nNon-nursing (specify)\nCourses in principles of teaching\nCourses in practice teaching (type)\nState teacher's certificate?\nWhere?\nForeign languages spoken\nIV. EXPERIENCE\nHospital or Organization\nCity and State\nNature of Work\nDates\nPerson in Charge\nVisiting Nurse Association\nChicago, Ill.\nStaff Nurse\n1909-12\nMiss Edna Foley\n\"\n\"\n\"\nSupervisor\n1912-18\n11\n\"\n11\nMetropolitan Life Ins. Co.\nNew York City\nTerritorial Supr. 1918-21\nDr. Lee K. Frankel\n\"\nIf\n\"\n\"\n\"\n\"\nSupt. of Nursing 1921-40\nDr.W.P.Shepard\nFor teaching experience indicate: elementary, secondary, normal, college, nursing, or other.\nHave you taught Red Cross Home Nursing (formerly Home Hygiene and Care of the Sick)?\nChapter\nCity and State\nType Groups\nDates\nV. EMPLOYMENT BASIS\n1. Type of work preferred: Rural\nUrban\nWill you accept either? Yes\n2. What State or localities do you prefer? Middle West Territory\n3. When will you be available? after Oct. 19, 1942.\n4. Can you drive a car?\nyes\nDo you own a car? No\n5. What dependents or family responsibilities do you have?\nNone\n6. Name of nearest relative to be notified in case of accident (relationship and address)\nMrs. Thomas Coughlan, 7962 Phillips Ave., Chicago, Illinois - daughter.\n7. Give name of placement service, if registered with one\n8. May we approach your present employer for references?\nYes\n9. Do you have good health?\nYes\n10. When did you have your last physical examination? January, 1941\nRemarks: no available pholograph\n(Please attach photograph\nof yourself, taken within\nthe past two years. )\nHelen La Malle\n(Signature of applicant)\nDate Oct 19, 1942"
}