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Form 1037 11-11-21 THE AMERICAN NATIONAL RED CROSS NURSING SERVICE Application for Enrollment (To be filled out entirely in applicant's handwriting and each question answered fully) 1. Name of applicant in full Florence Elizabeth Little 2. Address in full V Providence Rhode Island. 36 Burlington Street in 3. Date of birth aug 14, 1897 Race american Place of birth Providence, R. 9. Birthplace of father Providence R9 Mother Pror. R. 9. Citizenship of father united States- 4. Are you married, single or a widow? Single Are you a citizen of the United States? yes 5. How many years have you attended grammar school? 7yrs High school? 4 yrs Normal school? Private school? 0 College? 0 If tutored privately, name subjects covered and length of time 6. What languages other than English do you speak? none other. (Underline those which you speak fluently) 7. Occupation before entering training school asst. to industrial nurse 8. From what hospital training school did you receive your diploma? Rhode Island Hospital City and State Providence Rhode Island Date of graduation Oct. 3, 1923 Give name at time of graduation Flounce Elizabeth Little 9. Character of hospital: General? yes Special? no Private? no 10. Did your training include obstetrics? yes Care of men? yes 380 Children? yes Contagious diseases? yes 11. Daily average number of patients in hospital during training Length of course B years 12. Name and address of superintendent of training school under whom you received C. Lord of miss grau L. mac9ntyu (address ?) 12 Cambidge Ing mrs (deceased) 13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each affiliated Pnor. Lying In Hospital 4 months of Providence city Hospital(2mo) 14. Of what nursing organizations are you a member? R.9. Hospital nuses almm association " 15. Which, if any, is affiliated with the American Nurses' Association? " 16. Give name and address of secretary of at least one of these organizations miss C 2, Earley (Meas.) Sing miss 17. Fairly association main st, Part. B 2. Are you a registered nurse? In what State? R. Date of registration nor.26, 19 Number 1524 23 18. Type of work and length of service since graduation: with - Smith field Public Health League Smithfield, R.9. includes industrial 1923 nursing, school 1924 of rural district minisury ( Time) October 15, to July 29, (Present position) Smithfield Public Health League. 2nd assistant nurse 19. Will you be willing to accept active service if the United States becomes involved in war? yes 20. (a) If interested in accepting service within the near future, indicate choice: R. C. P. H. Nursing, Instructor, Home Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U.S. Veterans Bureau. (b) Date upon which you will be available as required 21. Are you willing to take the oath of allegiance? 22. Name and permanent address of near relative (give rela tionship) Hany B. Little, (Father) yes 36 Burlington st. Providence R. 9 Date July 29, 1924 Signature of nurse Florence Elizabeth Little R.n. NOTE. - Nurses who have had training or experience in Public Health Nursing will, in addition to the above, fill out questions 23 and 24 on reverse side of this blank. To The Committee: This blank is to be sent to applicant with circular letter Form 1199, together with Forms D. M. R. 2, 1193 and A. R. C. 703. Application forms after approval and endorsement by Local committee, with Forms 1244, 1189, 1193 should be forwarded to the director of the Nursing Service in your Division Office.

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    "ocrText": "Form 1037\n11-11-21\nTHE AMERICAN NATIONAL RED CROSS NURSING SERVICE\nApplication for Enrollment\n(To be filled out entirely in applicant's handwriting and each question answered fully)\n1. Name of applicant in full Florence Elizabeth Little\n2. Address in full\nV\nProvidence Rhode Island.\n36 Burlington Street\nin\n3. Date of birth aug 14, 1897\nRace american Place of birth Providence, R. 9.\nBirthplace of father Providence R9 Mother Pror. R. 9.\nCitizenship of father united States-\n4.\nAre you married, single or a widow? Single Are you a\ncitizen\nof\nthe\nUnited\nStates?\nyes\n5. How many years have you attended grammar school? 7yrs High school? 4 yrs Normal school?\nPrivate school?\n0\nCollege?\n0\nIf tutored privately, name subjects covered and length of time\n6. What languages other than English do you speak? none other.\n(Underline those which you speak fluently)\n7. Occupation before entering training school asst. to industrial nurse\n8. From what hospital training school did you receive your diploma? Rhode Island Hospital\nCity and State Providence Rhode Island Date of graduation Oct. 3, 1923\nGive name at time of graduation Flounce Elizabeth Little\n9.\nCharacter\nof\nhospital:\nGeneral?\nyes\nSpecial? no\nPrivate? no\n10. Did your training include obstetrics? yes Care of men? yes 380 Children? yes Contagious diseases? yes\n11. Daily average number of patients in hospital during training\nLength\nof\ncourse\nB\nyears\n12. Name and address of superintendent of training school under whom you received C. Lord\nof miss grau L. mac9ntyu (address ?) 12 Cambidge Ing mrs (deceased)\n13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each\naffiliated Pnor. Lying In Hospital 4 months of Providence city Hospital(2mo)\n14. Of what nursing organizations are you a member? R.9. Hospital nuses almm association\n\"\n15. Which, if any, is affiliated with the American Nurses' Association?\n\"\n16.\nGive name and address of secretary of at least one of these organizations miss C 2, Earley (Meas.)\nSing miss 17. Fairly association main st, Part. B 2.\nAre you a registered nurse? In what State? R. Date of registration nor.26, 19 Number 1524\n23\n18. Type of work and length of service since graduation:\nwith - Smith field Public Health League Smithfield, R.9.\nincludes industrial 1923 nursing, school 1924 of rural district minisury\n( Time) October 15, to July 29,\n(Present\nposition) Smithfield Public Health League. 2nd assistant nurse\n19. Will you be willing to accept active service if the United States becomes involved in war?\nyes\n20. (a) If interested in accepting service within the near future, indicate choice: R. C. P. H. Nursing, Instructor, Home\nHygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U.S. Veterans Bureau.\n(b) Date upon which you will be available as required\n21. Are you willing to take the oath of allegiance?\n22.\nName and permanent address of near relative (give rela tionship) Hany B. Little, (Father)\nyes\n36 Burlington st. Providence R. 9\nDate\nJuly 29, 1924 Signature of nurse Florence Elizabeth Little R.n.\nNOTE. - Nurses who have had training or experience in Public Health Nursing will, in addition to the above, fill\nout questions 23 and 24 on reverse side of this blank.\nTo The Committee:\nThis blank is to be sent to applicant with circular letter Form 1199, together with Forms D. M. R. 2, 1193 and\nA. R. C. 703. Application forms after approval and endorsement by Local committee, with Forms 1244, 1189, 1193\nshould be forwarded to the director of the Nursing Service in your Division Office."
}