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Form No. 200 DUPLICATE. Revised 2-15-18 AMERICAN RED CROSS No. 20385 SERVICE ENROLLMENT APPLICATION Date (OTHER THAN AS DOCTOR, SURGEON, ORNIRSE) 6/5/18 The questions should be answered as fully as possible, especially when an application for a passport may later be necessary. All answers must be in handwriting of applicant, I. Name in full STEPHENSON. IONE E. Telephone No. 2. Present Address 218 S. Cadwell Ave. Eagle Grove, Iowa (Number and Street) (City) (State) (a) If any changes of residence since August I, 1914, give these in full with dates. Chicago,I11.Aug.1/14 - Feb.9/15, Eagle Grove I. Feb.10/15, (b) What is your present business or profession? (Be specific.) Jan 29/17 Peoria, Ill. Jan 31/17 Mar.3/17 Eagle Grove, Ia. up to Graduate ,staying at home. present date. (c) What previous business or professional experience have you had, stating nature, places and principal dates thereof? Children's Mem. Hosp. Tr. School for Nurses 1912-1916, Visiting Rurse Assoe.n Peoria,Ill. 1917, Chicago I Surgical Nurse at home for Destitute Cripple Children 1917-18 (d) Have you ever lived in Europe? If so, give names of European countries in which you have resided and respective dates of residence in each. No (e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits. No (f) Since August I, 1914, have you applied for a United States passport? If so, state whether application was granted, denied or withdrawn. No 3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state militia. None except for Red Cross (a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex- amining official. Yes (b) Were you accepted, rejected, is result of examination pending: early in of 1918 Graham Accepted 4. Date of birth 1893 Mas 20 (a) Place of birth Eagle Grove, Ia. Year Month Day (b) Full name of father George William Stephenson, (c) Birthplace of fathers Haverly,Ia. (d) Nationality of father American (e) If father foreign born, whether naturalized and when No (f) Full maiden name of mother Mabel Frances Lindley, (g) Birthplace of mother St rling, Ill. (h) Nationality of mother American (i) If mother foreign born, whether naturalized and when No (j) Full name and nationality of paternal grandfather Thos Cha .Stephenson, American (k) Full maiden name and nationality of paternal grandmother Serah .Goforth, American (1) Full name and nationality of maternal grand father George Frank Lindley, American (m) Full maiden name and nationality of maternal grandmother. Harriet Wilson (n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives, if any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State nature and places of employment of each of such relatives not now in such war service. None (o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United States, specifying which ally in every case. None.

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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": "Form No. 200\nDUPLICATE.\nRevised 2-15-18\nAMERICAN RED CROSS\nNo. 20385\nSERVICE ENROLLMENT APPLICATION\nDate\n(OTHER THAN AS DOCTOR, SURGEON, ORNIRSE)\n6/5/18\nThe questions should be answered as fully as possible, especially when an application for a passport may later be necessary.\nAll answers must be in handwriting of applicant,\nI.\nName\nin full STEPHENSON. IONE E.\nTelephone No.\n2. Present Address 218 S. Cadwell Ave.\nEagle Grove,\nIowa\n(Number and Street)\n(City)\n(State)\n(a) If any changes of residence since August I, 1914, give these in full with dates.\nChicago,I11.Aug.1/14 - Feb.9/15, Eagle Grove I. Feb.10/15,\n(b) What is your present business or profession? (Be specific.) Jan 29/17 Peoria, Ill. Jan 31/17\nMar.3/17 Eagle Grove, Ia. up to\nGraduate ,staying at home. present date.\n(c) What previous business or professional experience have you had, stating nature, places and principal\ndates thereof?\nChildren's Mem. Hosp. Tr. School for Nurses 1912-1916, Visiting\nRurse Assoe.n Peoria,Ill. 1917, Chicago I Surgical Nurse\nat home for Destitute Cripple Children 1917-18\n(d) Have you ever lived in Europe? If so, give names of European countries in which you have resided\nand respective dates of residence in each.\nNo\n(e) Have you ever traveled in Europe? If so, name countries visited, with respective dates of visits.\nNo\n(f) Since August I, 1914, have you applied for a United States passport? If so, state whether application\nwas granted, denied or withdrawn.\nNo\n3. State fully your participation in war service of U. S., or any of Allies or of enemy, or in that of any state\nmilitia.\nNone except for Red Cross\n(a) Have you ever been examined for war service? If so, state when, where and, if possible, name of ex-\namining official.\nYes\n(b) Were you accepted, rejected, is result of examination pending:\nearly\nin\nof\n1918\nGraham\nAccepted\n4. Date of birth 1893\nMas\n20\n(a) Place of birth Eagle Grove, Ia.\nYear\nMonth\nDay\n(b) Full name of father\nGeorge William Stephenson,\n(c) Birthplace of fathers Haverly,Ia.\n(d) Nationality of father\nAmerican\n(e) If father foreign born, whether naturalized and when No\n(f) Full maiden name of mother Mabel Frances Lindley,\n(g) Birthplace of mother St rling,\nIll.\n(h) Nationality of mother American\n(i) If mother foreign born, whether naturalized and when\nNo\n(j) Full name and nationality of paternal grandfather Thos Cha .Stephenson, American\n(k) Full maiden name and nationality of paternal grandmother Serah .Goforth, American\n(1) Full name and nationality of maternal grand father George Frank Lindley, American\n(m) Full maiden name and nationality of maternal grandmother. Harriet Wilson\n(n) Names of all relatives nearer than second cousins living in Europe, specifying which of said relatives,\nif any, are now or have been in the war service of Germany, Austria, Bulgaria or Turkey. State\nnature and places of employment of each of such relatives not now in such war service.\nNone\n(o) Names of all relatives nearer than second cousins in the war service of any of the allies of the United\nStates, specifying which ally in every case.\nNone."
}