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M Hawair Unit - -Ret to were amick Confidential FORM 1219 REV. JUNE 1942 Please return AMERICAN RED CROSS APPLICATION FOR EMPLOYMENT - NURSING PERSONNEL Feft I. PERSONAL Name in full Miss Reba Elizabeth Mumma Badge (No. (H.D. 11,911 (MISS OR MRS.) (IF MARRIED, GIVE MAIDEN NAME ALSO) Not enrolled Present address 2136 Fulton St. Apt 4 Toledo llio Tel. No. Ma. 8593 (STREET) (CITY) (STATE) Permanent address 1474 Neil Avenue, Columbus this Tel. No. Un 7361 (STREET) (CITY) (STATE) Citizenship yes Color white Place of birth Reynn this 2nd Present position staff nurse - (1500 years 1(1620 sincrease).) year Date of birth June 2.0 1916 (TITLE) (SALARY) Toledo District Nurse Assin 1903 Mouroe St. Toledo this Single Widowed (ORGANIZATION) (ADDRESS) Married Divorced II. PROFESSIONAL STATUS States registered ahio Current registration yes Tho - 33317 To what professional organizations you belong? Ohio State university Hospital do Registration with this State nurses Dist #9 funding If not an enrolled Red Cross nurse, has your application for enrollment been submitted to your Local Committee Red Cross Nursing Service? (NOT chapter committee) When and to whom? III. EDUCATION 1. Prior to entering school of nursing: Name City and State Dates Diploma-Degree Major High School North High School Columbus. Ohio 1930-1933 yes. Acadeuise Course Normal School University this tote University Columbus, lluin 1936-1939 Other 2. School of nursing from) dhio State University (NAME) Hospital Colume lhos which you graduated) (CITY) (STATE) Length of course 5 years 3 years (Specify other) Date completed Dec 19,1941 3. Undergraduate affiliations: Hospital or Organization City and State Clinical Specialty No. Months (1) Instructive District NurseAsin Columbus, this Public Health (2) (3) I 4. Postgraduate clinical courses: (Do not include academic work or employment.) Hospital or Organization City and State Clinical Specialty Dates D (1) (2) (3) 5. Academic study since graduation from school of nursing: College or University City and State Academic years No. Points (1) (2) (3)

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    "ocrText": "M\nHawair Unit - -Ret to were amick\nConfidential\nFORM 1219\nREV. JUNE 1942\nPlease return\nAMERICAN RED CROSS\nAPPLICATION FOR EMPLOYMENT - NURSING PERSONNEL\nFeft\nI. PERSONAL\nName in full Miss Reba Elizabeth Mumma\nBadge (No.\n(H.D. 11,911\n(MISS OR MRS.)\n(IF MARRIED, GIVE MAIDEN NAME ALSO)\nNot enrolled\nPresent address 2136 Fulton St. Apt 4 Toledo llio\nTel. No. Ma. 8593\n(STREET)\n(CITY)\n(STATE)\nPermanent address 1474 Neil Avenue, Columbus this\nTel. No. Un 7361\n(STREET)\n(CITY)\n(STATE)\nCitizenship yes\nColor white\nPlace of birth Reynn this\n2nd\nPresent position staff nurse - (1500 years 1(1620 sincrease).) year Date of birth June 2.0 1916\n(TITLE)\n(SALARY)\nToledo District Nurse Assin 1903 Mouroe St. Toledo this\nSingle\nWidowed\n(ORGANIZATION)\n(ADDRESS)\nMarried\nDivorced\nII. PROFESSIONAL STATUS\nStates registered ahio\nCurrent registration yes Tho - 33317\nTo what professional organizations you belong? Ohio State university Hospital\ndo\nRegistration with this State nurses Dist #9 funding\nIf not an enrolled Red Cross nurse, has your application for enrollment been submitted to\nyour Local Committee Red Cross Nursing Service? (NOT chapter committee)\nWhen and to whom?\nIII. EDUCATION\n1. Prior to entering school of nursing:\nName\nCity and State Dates Diploma-Degree\nMajor\nHigh School North High School\nColumbus. Ohio\n1930-1933\nyes.\nAcadeuise Course\nNormal School\nUniversity this tote University\nColumbus, lluin\n1936-1939\nOther\n2. School of nursing from) dhio State University (NAME) Hospital Colume lhos\nwhich you graduated)\n(CITY)\n(STATE)\nLength of course\n5 years\n3 years\n(Specify other)\nDate completed Dec 19,1941\n3. Undergraduate affiliations:\nHospital or Organization\nCity and State\nClinical Specialty No. Months\n(1) Instructive District NurseAsin\nColumbus, this\nPublic Health\n(2)\n(3)\nI\n4. Postgraduate clinical courses: (Do not include academic work or employment.)\nHospital or Organization\nCity and State\nClinical Specialty\nDates\nD\n(1)\n(2)\n(3)\n5. Academic study since graduation from school of nursing:\nCollege or University\nCity and State\nAcademic years\nNo. Points\n(1)\n(2)\n(3)"
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