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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
0
Type
photo
Media ID
a19a7573650c8627
Size
unknown

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ID
2661789
Core
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Type
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Document identity
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Document source metadata
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Document source extras
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    "naId": 2661789,
    "coverageEndDate": {
        "day": 10,
        "logicalDate": "1946-04-10",
        "month": 4,
        "year": 1946
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        "logicalDate": "1926-05-04",
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Page context
{
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    "mediaId": "a19a7573650c8627",
    "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"
}