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Form 1037 4-23-24 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 Ella Elizabeth mcneil /38%12 W. arch St. mansfield ohio 2. Address in full 24166 1/3. Date of birth Tecumsch Michigan Race American Place of birth. Nov. 25.1900 Birthplace of father Michigan Mother new York Citizenship of father. u.s. 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 ? 8 High school ? 4 Normal school? - Private school ? - College ? 3 if tutored privately, name subjects covered and length of time 5 ye. combined nursing course B.S. Degree . 6. What languages other than English do you speak? none (Underline those which you speak fluently) 7. Occupation before entering training school Student 8. From what hospital training school did you receive your diploma ? University of michigan City and State annarboy. Michigan Date of graduation June 1923 Give name at time of graduation Ella mc neil 9. Character of hospital: General ? general Special ? Private? 10. Did your training include obstetrics? yes Care of men ? yes Children ? yes Contagious diseases yes 11. Daily average number of patients in hospital during training 500 Length of course 2 yrs 12. Name and address of superintendent of nurses under whom you received training mary Q.Welch Blodgert. Hospital grand Rapoda,Mich. hourse Gliem Battle Creek aanitarium Battle Creckmich. 13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each 14. Of what nursing organizations are you a member ? Mich. state assoc. ,District aasocannabor, mich diumni assoc. anna n.o.P.A.n 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 Violet Tessin u of m Hospital annavbor, michigan Sec Glumni assoc. 17. Are you a registered nurse ? yes in what State Mich Date of registration 10/15/23 Number 6821 ionio 18. Type of work and length of service since graduation: assistant Supt. of nurses University Hospital ann Arbor Mich Pablic Hearth Child Health Demon staten mansfield ohio. (Present position) hast above. 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 21. Are you willing to take the oath of allegiance ?. yes 22. Name and permanent address of near relative (give relationship) Mother, Mrs. Helen maneil 215 W. Shawnee St. Tecumson-Mich. Date 1-28-25 Signature of nurse. Ella moniel 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 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. 4

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    "ocrText": "Form 1037\n4-23-24\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 Ella Elizabeth mcneil\n/38%12 W. arch St. mansfield ohio\n2. Address in full\n24166\n1/3.\nDate of birth Tecumsch Michigan Race American Place of birth. Nov. 25.1900\nBirthplace of father Michigan Mother new York\nCitizenship of father. u.s.\n4. Are you married, single or a widow ? Single Are you a citizen of the United States yes\n5. How many years have you attended grammar school ? 8 High school ? 4 Normal school? -\nPrivate school ?\n- College ? 3 if tutored privately, name subjects covered and length of time\n5 ye. combined nursing course B.S. Degree .\n6. What languages other than English do you speak?\nnone\n(Underline those which you speak fluently)\n7. Occupation before entering training school\nStudent\n8.\nFrom what hospital training school did you receive your diploma ? University of michigan\nCity and State annarboy. Michigan\nDate of graduation June 1923\nGive name at time of graduation Ella mc neil\n9. Character of hospital: General ? general\nSpecial ?\nPrivate?\n10. Did your training include obstetrics? yes Care of men ? yes Children ? yes Contagious diseases yes\n11. Daily average number of patients in hospital during training 500\nLength of course 2 yrs\n12. Name and address of superintendent of nurses under whom you received training mary Q.Welch Blodgert.\nHospital grand Rapoda,Mich. hourse Gliem Battle Creek aanitarium Battle Creckmich.\n13. If your training as a nurse was received in more than one hospital, give name, location and time spent in each\n14. Of what nursing organizations are you a member ? Mich. state assoc. ,District aasocannabor,\nmich diumni assoc. anna n.o.P.A.n\n15. Which, if any, is affiliated with the American Nurses' Association ?\n16. Give name and address of secretary of at least one of these organizations Violet Tessin u of m\nHospital annavbor, michigan Sec Glumni assoc.\n17.\nAre you a registered nurse ? yes in what State Mich Date of registration 10/15/23 Number 6821\nionio\n18. Type of work and length of service since graduation:\nassistant Supt. of nurses University Hospital ann Arbor Mich\nPablic Hearth Child Health Demon staten mansfield ohio.\n(Present position)\nhast above.\n19. Will you be willing to accept active service if the United States becomes involved in war? yes\n20.\n(a) If interested in accepting service within the near future, indicate choice: R. C. P. H. Nursing, Instructor,\nHome Hygiene and Care of Sick, Army, Navy, U. S. Public Health Service, U. S. Veterans Bureau.\n(b) Date upon which you will be available\n21. Are you willing to take the oath of allegiance ?. yes\n22. Name and permanent address of near relative (give relationship)\nMother, Mrs. Helen maneil 215 W. Shawnee St. Tecumson-Mich.\nDate 1-28-25\nSignature of nurse. Ella moniel\nNOTE -Nurses who have had training or experience in Public Health Nursing will, in addition to the above, fill out questions\n23 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 2, 1193 and A. R. C.\n703. Application forms after approval and endorsement by Local committee, with Forms 1244, 1189, 1193 should\nbe forwarded to the Director of the Nursing Service in your Division Office.\n4"
}