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M
DEC151943
FORM 1045
REV. OCT. 1943
AMERICAN RED CROSS
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
I
Red Cross
Badge number H.D5231
If you have changed your last name
since contacting us, please check here.
a
Name in full Mac Donald Ida
Mildred
Tel. No. Qr. 1367
(last)
(first)
(middle)
ANI
a
If married, give maiden name
Date of birth Nov. 13, 1899
Marital status
Husband's name
Mi
(single, married, widowed divoreed)
Permanent address Rozali cepts. missoula montona % Edth mac Donald
/
(street)
(city)
(county)
(state)
Present address 4923 Brandgerine (street) n.w. (city) wash (county) D.C
a
(state)
Notify national headquarters immediately if you change your address.
Give name and address of nearest relative or friend in the United States:
Edith mae Donald
Messoula montana
Sister
(name)
(address)
(relationship)
Are you employed in nursing at the present time? Yes
No
If employed, check the type of work you are doing and fill in below the title of your position and the name
and address of the agency or institution:
Institutional
Public Health
Industrial
Private Duty
Other
am Red Crass. Associate Derector Valuateen nurse's addes
If not employed, what type of nursing would you prefer to render?
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you:
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason ? Family responsibility (spedify)
Do you have any dependents under 14 years of age? Yes
No
I
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
is
To teach Red Cross Home Nursing classes?
To
teach volunteer nurse's aides? Have taught me class m past year
To take a Red Cross emergency assignment?
5
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No x
Story
I
W
If yes, specify type of disaster
Page data
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- Source index
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- Type
- photo
- Media ID
- 078726a152188fde
- Size
- unknown
Document data
- ID
- 2661860
- Core
- doc
- Type
- document
DTO data
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"ocrText": "M\nDEC151943\nFORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nI\nRed Cross\nBadge number H.D5231\nIf you have changed your last name\nsince contacting us, please check here.\na\nName in full Mac Donald Ida\nMildred\nTel. No. Qr. 1367\n(last)\n(first)\n(middle)\nANI\na\nIf married, give maiden name\nDate of birth Nov. 13, 1899\nMarital status\nHusband's name\nMi\n(single, married, widowed divoreed)\nPermanent address Rozali cepts. missoula montona % Edth mac Donald\n/\n(street)\n(city)\n(county)\n(state)\nPresent address 4923 Brandgerine (street) n.w. (city) wash (county) D.C\na\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nEdith mae Donald\nMessoula montana\nSister\n(name)\n(address)\n(relationship)\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nam Red Crass. Associate Derector Valuateen nurse's addes\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you:\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ? Family responsibility (spedify)\nDo you have any dependents under 14 years of age? Yes\nNo\nI\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nis\nTo teach Red Cross Home Nursing classes?\nTo\nteach volunteer nurse's aides? Have taught me class m past year\nTo take a Red Cross emergency assignment?\n5\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo x\nStory\nI\nW\nIf yes, specify type of disaster"
}