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No. 1
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
I. Name of applicant Naunie Jacqueline minor
2. Address in full 2.07 E. Carly St Richmond yes
40
3. Date of birth June 13-4-1871 Place of birth of Virginia
4. or a
Are you married, single, widow ? Single
5. Are you a citizen of the United States? yes
6. Have you any physical defects?
no
us
7. Education and occupation before entering Training School Home t 2 at Boarding
School
8. From what Training School did you graduate? old Dominion Hospital
Richmond ra
9. Character of hospital General yes
Special? -
Private? -
IO. How beds in about 100
many hospital at time of graduation?
II. Date of graduation June 1900
Length of course 2 you
12. Name and address of Superintendent of Training School under whom you were trained
miss S. H. Cahanies Bearer Dam va T.I.D
School
I3. Of what nursing organization are you a member ? Alumnae Richmond hurein
Club State Association
14. Give name and address of Secretary miss E R.P.P.Cocke Bow air for (O.D.H Alummar ass.)
I5. Are you a registered nurse? yes In what State? ya
Date of registration Feb 18-1904
d.
16. How and where have been since Give information for each District
you employed graduation? year
nursing in Richmond since 1901-
17. Name and permanent address of nearest relative Mr. Johns B. Munor
1133 West ave. Richmond
Date. march 14"
ya
Signature Namie Jacqueline minor
This blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded
with
credentials" (Form Nos. 3 and 4), to the Chairman National Committee on Red Cross Nursing Service, Washington, D. C.
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- Core
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"ocrText": "No. 1\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nI. Name of applicant Naunie Jacqueline minor\n2. Address in full 2.07 E. Carly St Richmond yes\n40\n3. Date of birth June 13-4-1871 Place of birth of Virginia\n4. or a\nAre you married, single, widow ? Single\n5. Are you a citizen of the United States? yes\n6. Have you any physical defects?\nno\nus\n7. Education and occupation before entering Training School Home t 2 at Boarding\nSchool\n8. From what Training School did you graduate? old Dominion Hospital\nRichmond ra\n9. Character of hospital General yes\nSpecial? -\nPrivate? -\nIO. How beds in about 100\nmany hospital at time of graduation?\nII. Date of graduation June 1900\nLength of course 2 you\n12. Name and address of Superintendent of Training School under whom you were trained\nmiss S. H. Cahanies Bearer Dam va T.I.D\nSchool\nI3. Of what nursing organization are you a member ? Alumnae Richmond hurein\nClub State Association\n14. Give name and address of Secretary miss E R.P.P.Cocke Bow air for (O.D.H Alummar ass.)\nI5. Are you a registered nurse? yes In what State? ya\nDate of registration Feb 18-1904\nd.\n16. How and where have been since Give information for each District\nyou employed graduation? year\nnursing in Richmond since 1901-\n17. Name and permanent address of nearest relative Mr. Johns B. Munor\n1133 West ave. Richmond\nDate. march 14\"\nya\nSignature Namie Jacqueline minor\nThis blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded\nwith\ncredentials\" (Form Nos. 3 and 4), to the Chairman National Committee on Red Cross Nursing Service, Washington, D. C."
}