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1045 Rev. 1-7-30
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER. PRESIDENT
JOHN BARTON PAYNE. CHAIRMAN
ROBERT w. DE FOREST. VICE PRESIDENT
MRS. AUGUST BELMONT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
CALVIN COOLIDGE, VICE PRESIDENT
JOSEPH P. COTTON
CHARLES EVANS HUGHES, JR.. COUNSELOR
NATIONAL HEADQUARTERS
MRS. HENRY P. DAVISON
E. B. DOUGLAS
OGDEN L. MILLS, TREASURER
WASHINGTON, D.C.
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN. SECRETARY
CHARLES EVANS HUGHES, JR.
MAJ. GEN. M. W. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
GUSTAVUS D. POPE
JOHN BARTON PAYNE, CHAIRMAN
MRS. HENRY R. REA
JAMES L. FIESER. VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
JOHN D. RYAN
ERNEST P. BICKNELL, VICE CHAIRMAN
GEORGE E. SCOTT
JAMES K. McCLINTOCK, VICE CHAIRMAN
ELIOT WADSWORTH
V
Dear Madam:
man 19- to
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in enclosed envelope, at the earliest possible date.
IMPORTANT:
Yours sincerely,
In order to render prompt service
in time of disaster, enrolled Red Cross
Miss Florence Black
Chairman or
nurses should report at once to the
Secretary; Local Committee
Secretary.
Secretary of the Local Committee under
Red Cross Nursing Service Local Committee.
which they are enrolled. Do not forget
922 floyd Avenue
the address of the Secretary.
Richmond, Va.
Name in full
If married, give husband's name
Permanent address
have. Richmond
(STREET, ETC.)
Virginia
(CITY)
(COUNTY)
(STATE)
Probable address for the next year
Same
(STREET, ETC.)
Telephone No.
(CITY)
(COUNTY)
(STATE)
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
John
other
1702 Park are. Richmond v-
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been?
Indicate present physical condition fair
able
Would you an emergency call in event of
Badge No.
1338 respond to epidemic, March disaster, war, etc.
Current date 14 1930
NOTE.--If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "1045 Rev. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER. PRESIDENT\nJOHN BARTON PAYNE. CHAIRMAN\nROBERT w. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nJOSEPH P. COTTON\nCHARLES EVANS HUGHES, JR.. COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nE. B. DOUGLAS\nOGDEN L. MILLS, TREASURER\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN. SECRETARY\nCHARLES EVANS HUGHES, JR.\nMAJ. GEN. M. W. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. HENRY R. REA\nJAMES L. FIESER. VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nERNEST P. BICKNELL, VICE CHAIRMAN\nGEORGE E. SCOTT\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nELIOT WADSWORTH\nV\nDear Madam:\nman 19- to\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nMiss Florence Black\nChairman or\nnurses should report at once to the\nSecretary; Local Committee\nSecretary.\nSecretary of the Local Committee under\nRed Cross Nursing Service Local Committee.\nwhich they are enrolled. Do not forget\n922 floyd Avenue\nthe address of the Secretary.\nRichmond, Va.\nName in full\nIf married, give husband's name\nPermanent address\nhave. Richmond\n(STREET, ETC.)\nVirginia\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nSame\n(STREET, ETC.)\nTelephone No.\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nJohn\nother\n1702 Park are. Richmond v-\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been?\nIndicate present physical condition fair\nable\nWould you an emergency call in event of\nBadge No.\n1338 respond to epidemic, March disaster, war, etc.\nCurrent date 14 1930\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}