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M
FORM 1082
PUBLIC HEALTH NURSING AND HOME HYGIENE
REV. 3-22-37
RETURN IN DUPLICATE
AND CARE OF THE SICK SERVICE
2-13-47
AMERICAN NATIONAL RED CROSS
special
N.H.
Hennifini C.
minnesota
INSTRUCTOR'S APPLICATION
I
Please fill out this form and RETURN to Public Health Nursing and Home Hygiene and Care of
the Sick Service. Fill out each item in detail.
a
1. GENERAL INFORMATION:
Name in full mae Donald Sda medical Red
Cross Badge
No.
Present address 815 Essex (STREET) St S.E minnergoles (CITY) meri H.D. (STATE)
5231
Mi
,
Present position asst Cap nursing Education Unid Humanols school
-
Date of birth Nov.13,189.9 Racé Scale Citizenship u.s.
Health Excellent nursing
Single, married, separated, widowed or divorced? (Underline) If applying for a position
state your preference and limitation locality minneyolis
as to
2. NURSING EDUCATION:
Name of School of Nursing Hospital School of Nursing
Prehyterisin
Date of
Location checage, see Graduation Apre 1931
Ill 1931
Registration new
(STATE)
(YEAR)
Postgraduate work
(INCLUDING PUBLIC HEALTH COURSES)
(TYPES OF WORK)
(DATE)
If not an enrolled Red Cross nurse, have application papers been submitted to the Local
Red Cross Nursing Committee?
Rejected for usual defect 992 When?
To whom?
3. OTHER EDUCATION:
Diplomas and
Name and location
Dates attending
degrees rec'd.
High school or
equivalent missaula Country High Schwel Missouli mentons 914-18
I
Normal
College montona state university missoular mont. 1918-22
B.A.
Summer schools 24 ganaaton credits Is of nuna + 23 graduate credits us
Ede Pengahology (Unis of minnesstal
5
Special course
principles of teaching in undergraduate cate and supervision of qualification curses would to teach, schools lending t to courses neurong university in Teaching Certifi-
I
3
Did course yes
above include practice teaching?
PLEASE ANSWER QUESTIONS ON REVERSE SIDE
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"ocrText": "M\nFORM 1082\nPUBLIC HEALTH NURSING AND HOME HYGIENE\nREV. 3-22-37\nRETURN IN DUPLICATE\nAND CARE OF THE SICK SERVICE\n2-13-47\nAMERICAN NATIONAL RED CROSS\nspecial\nN.H.\nHennifini C.\nminnesota\nINSTRUCTOR'S APPLICATION\nI\nPlease fill out this form and RETURN to Public Health Nursing and Home Hygiene and Care of\nthe Sick Service. Fill out each item in detail.\na\n1. GENERAL INFORMATION:\nName in full mae Donald Sda medical Red\nCross Badge\nNo.\nPresent address 815 Essex (STREET) St S.E minnergoles (CITY) meri H.D. (STATE)\n5231\nMi\n,\nPresent position asst Cap nursing Education Unid Humanols school\n-\nDate of birth Nov.13,189.9 Racé Scale Citizenship u.s.\nHealth Excellent nursing\nSingle, married, separated, widowed or divorced? (Underline) If applying for a position\nstate your preference and limitation locality minneyolis\nas to\n2. NURSING EDUCATION:\nName of School of Nursing Hospital School of Nursing\nPrehyterisin\nDate of\nLocation checage, see Graduation Apre 1931\nIll 1931\nRegistration new\n(STATE)\n(YEAR)\nPostgraduate work\n(INCLUDING PUBLIC HEALTH COURSES)\n(TYPES OF WORK)\n(DATE)\nIf not an enrolled Red Cross nurse, have application papers been submitted to the Local\nRed Cross Nursing Committee?\nRejected for usual defect 992 When?\nTo whom?\n3. OTHER EDUCATION:\nDiplomas and\nName and location\nDates attending\ndegrees rec'd.\nHigh school or\nequivalent missaula Country High Schwel Missouli mentons 914-18\nI\nNormal\nCollege montona state university missoular mont. 1918-22\nB.A.\nSummer schools 24 ganaaton credits Is of nuna + 23 graduate credits us\nEde Pengahology (Unis of minnesstal\n5\nSpecial course\nprinciples of teaching in undergraduate cate and supervision of qualification curses would to teach, schools lending t to courses neurong university in Teaching Certifi-\nI\n3\nDid course yes\nabove include practice teaching?\nPLEASE ANSWER QUESTIONS ON REVERSE SIDE"
}