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(p) Names of all relatives nearer than second cousins in the war service of the United States Government.
None
5. If foreign born, give date and court of your naturalization
None
6. Single, married, widow, or widower Single
(a) Number of dependents None
(b) Full name and address of nearest relative or friend Sister, Ursula Mabel Stephenson,
218 S. Cadwell Ave., Eagle Grove, Ia.
(c) Full name of wife before marriage; or husband
None
(d) Birthplace of wife or husband
None
(e) Nationality of wife or husband
None
(f) Birthplace and nationality of father of wife or husband
None
(g) Birthplace and nationality of mother of wife or husband
None
7. Kind of service preferred. (Specify.) Red Cross Infant welfare
8. Would you enter foreign service?
Yes
(a) If so, in what country or countries
France
(b) Describe fully any experience you have ever had in service of the American Red Cross.
None
9. Would you serve without pay and defray all of your necessary expenses ?
No
(a) With only expenses defrayed for you?
No
(b) If not, what minimum salary would you require in addition to the defraying of your expenses?
$65.00 whatev the Red Cross pays
IO. What University or College attended?
None
Year graduated
-
II. Can you speak French fluently
No
(a) If not, to what degree, if any ?
No
(b) Can you translate French easily ?
No
(c) If not, to what degree, if any ? No
12. What other foreign languages do you speak?
None
(a) State extent of your knowledge of each
I3. As references, give names and addresses of three American citizens not related to you.
Rev. H. Fay Tyler, Eagle Grove, Ia.
R.M. Smallpage, Eagle Grove, Ia.
Focht, Eagle Grove, Iowa.
14. Give names and addresses of all patriotic, beneficial, social or other form of clubs, societies or other organiza-
tions based on race, nationality, etc., to which you belong or have at any time belonged, since August I, 1914
Alumnae of the Childrens Memo: isl Hospital of Chicago, Ill
I5. If enrolled in service, name earliest date you could take up work June 15/18
I hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.
Ione B.Stephenson.
Signature.
Division Personnel Committee examining application
Date of report
Report of Committee. (Be specific.)
Date of receipt at National Headquarters
Checked by
Comments
Page data
- Page
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- Source index
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- Type
- photo
- Media ID
- cc52f12596644d65
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Document data
- ID
- 2661790
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "(p) Names of all relatives nearer than second cousins in the war service of the United States Government.\nNone\n5. If foreign born, give date and court of your naturalization\nNone\n6. Single, married, widow, or widower Single\n(a) Number of dependents None\n(b) Full name and address of nearest relative or friend Sister, Ursula Mabel Stephenson,\n218 S. Cadwell Ave., Eagle Grove, Ia.\n(c) Full name of wife before marriage; or husband\nNone\n(d) Birthplace of wife or husband\nNone\n(e) Nationality of wife or husband\nNone\n(f) Birthplace and nationality of father of wife or husband\nNone\n(g) Birthplace and nationality of mother of wife or husband\nNone\n7. Kind of service preferred. (Specify.) Red Cross Infant welfare\n8. Would you enter foreign service?\nYes\n(a) If so, in what country or countries\nFrance\n(b) Describe fully any experience you have ever had in service of the American Red Cross.\nNone\n9. Would you serve without pay and defray all of your necessary expenses ?\nNo\n(a) With only expenses defrayed for you?\nNo\n(b) If not, what minimum salary would you require in addition to the defraying of your expenses?\n$65.00 whatev the Red Cross pays\nIO. What University or College attended?\nNone\nYear graduated\n-\nII. Can you speak French fluently\nNo\n(a) If not, to what degree, if any ?\nNo\n(b) Can you translate French easily ?\nNo\n(c) If not, to what degree, if any ? No\n12. What other foreign languages do you speak?\nNone\n(a) State extent of your knowledge of each\nI3. As references, give names and addresses of three American citizens not related to you.\nRev. H. Fay Tyler, Eagle Grove, Ia.\nR.M. Smallpage, Eagle Grove, Ia.\nFocht, Eagle Grove, Iowa.\n14. Give names and addresses of all patriotic, beneficial, social or other form of clubs, societies or other organiza-\ntions based on race, nationality, etc., to which you belong or have at any time belonged, since August I, 1914\nAlumnae of the Childrens Memo: isl Hospital of Chicago, Ill\nI5. If enrolled in service, name earliest date you could take up work June 15/18\nI hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.\nIone B.Stephenson.\nSignature.\nDivision Personnel Committee examining application\nDate of report\nReport of Committee. (Be specific.)\nDate of receipt at National Headquarters\nChecked by\nComments"
}