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FORM 1045
REV. OCT. 1943
e
AMERICAN RED CROSS
-
NURSING SERVICE
le ,
5
ANNUAL QUESTIONNAIRE-1944
If you have changed your last name
Red Cross
since contacting us, please check here.
D
Badge number 42658
Name in full
McNutt
Helen
Aldine
Tel. No. 66043
(last)
(middle)
a
(first)
Date of
birth March 31,1898
If married, give maiden name
,
Single
Husband's name
Marital status
(single, married, widowed, divorced)
e
2505 173Id
Hammond
Lake
Indiana
Permanent address
(street)
(city)
(county)
(state)
Present address 1742 Nuuanu
Honolulu
Oahu
T.H.
(street)
(city)
(county)
(state)
Notify national headquarters immediately if you change your address.
Give name and address of nearest relative or friend in the United States:
2505 173rd St. Hammond, Indiana
sister
Mrs. E. Kroll
(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
Night Supervisor, Sacred Hearts Hospital, Honolulu, T.H.
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, under and under 45. She 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and of
may be single or married, but if married she must have no dependents under 14 years 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 ?
Age
(specify)
Do you have any dependents under 14 years of age? Yes
No
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
To teach Red Cross Home Nursing classes?
8/2/
To teach volunteer nurse's aides'
To take a Red Cross emergency assignment? Yes
Xy
To serve overseas caring for civilians?
Yes. I wish to serve with the Red Cross at
any advance Pacific bases
Have you ever served with the Red Cross in a disaster? Yes
No
The Sacred Hearts Hosp.
If yes, specify type of disaster
is closing soon.
Page data
- Page
- 16
- Source index
- 0
- Type
- photo
- Media ID
- 5d4ba695a8860c96
- Size
- unknown
Document data
- ID
- 2661952
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "3\nu\nI\nFORM 1045\nREV. OCT. 1943\ne\nAMERICAN RED CROSS\n-\nNURSING SERVICE\nle ,\n5\nANNUAL QUESTIONNAIRE-1944\nIf you have changed your last name\nRed Cross\nsince contacting us, please check here.\nD\nBadge number 42658\nName in full\nMcNutt\nHelen\nAldine\nTel. No. 66043\n(last)\n(middle)\na\n(first)\nDate of\nbirth March 31,1898\nIf married, give maiden name\n,\nSingle\nHusband's name\nMarital status\n(single, married, widowed, divorced)\ne\n2505 173Id\nHammond\nLake\nIndiana\nPermanent address\n(street)\n(city)\n(county)\n(state)\nPresent address 1742 Nuuanu\nHonolulu\nOahu\nT.H.\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\n2505 173rd St. Hammond, Indiana\nsister\nMrs. E. Kroll\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\nNight Supervisor, Sacred Hearts Hospital, Honolulu, T.H.\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, under and under 45. She 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and of\nmay be single or married, but if married she must have no dependents under 14 years 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 ?\nAge\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\n8/2/\nTo teach volunteer nurse's aides'\nTo take a Red Cross emergency assignment? Yes\nXy\nTo serve overseas caring for civilians?\nYes. I wish to serve with the Red Cross at\nany advance Pacific bases\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nThe Sacred Hearts Hosp.\nIf yes, specify type of disaster\nis closing soon."
}