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Kf
6.
Check all degrees obtained subsequent to entering training:
Bachelor's Degree
Master's Degree
Certificate in Public Health Nursing
7. In which major field was your academic study?
Institutional
Public Health
Other (specify)
Non-nursing (specify)
Courses in principles of teaching
ar
1
Courses in practice teaching (type)
State teacher's certificate?
Where?
Foreign languages spoken
none
1021
IV. EXPERIENCE
Hospital or Organization City and State Nature of Work Dates Person in Charge
St. Josephs Hospital
Kouisvit Fexington Key Operating Durgicial nuese 11924 1925 Sri Jasellas.
St. ann's Pediatric
new yarility 1928029 mather Seeper.
fairz Diseases Hosp newyork Floor duty Relief miss hanting
new York Health Hipt. Penilica by Private Public Duty Health 1932-1933 hursing Misse to date Gears.
e
For teaching experience indicate: elementary, secondary, normal college, nursing, or other.
Have you taught Red Cross Home Nursing (formerly Home Hygiene and Care of the Sick)?
Chapter
City and State
Type Groups
Dates
V. EMPLOYMENT BASIS
1. Type of work preferred: Rural
Urban
Will you accept either? Yes.
2. What State or localities do you prefer? any
3. When will you be available?
at.
onco
4. Can you drive a car?
5. What dependents or family responsibilities do you have?
yes
Do you own a car? no
none
6.
Name of nearest relative to be notified in case of accident (relationship and address)
Wm.J. Connor. -Santa Moniga California
7.
8. May we approach your present employer for references? yes
Give name of placement service, if registered, Mrsh Sullivan's with one Miss Regle Reg/+
10. 9. When Do you did have you good have health? your last Yes. physical examination? June. 1942
Remarks:
(Please attach photograph
of yourself, taken within
the past two years.)
Likely L. of applicant) Channore
(Signature
Date
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"ocrText": "Kf\n6.\nCheck all degrees obtained subsequent to entering training:\nBachelor's Degree\nMaster's Degree\nCertificate in Public Health Nursing\n7. In which major field was your academic study?\nInstitutional\nPublic Health\nOther (specify)\nNon-nursing (specify)\nCourses in principles of teaching\nar\n1\nCourses in practice teaching (type)\nState teacher's certificate?\nWhere?\nForeign languages spoken\nnone\n1021\nIV. EXPERIENCE\nHospital or Organization City and State Nature of Work Dates Person in Charge\nSt. Josephs Hospital\nKouisvit Fexington Key Operating Durgicial nuese 11924 1925 Sri Jasellas.\nSt. ann's Pediatric\nnew yarility 1928029 mather Seeper.\nfairz Diseases Hosp newyork Floor duty Relief miss hanting\nnew York Health Hipt. Penilica by Private Public Duty Health 1932-1933 hursing Misse to date Gears.\ne\nFor teaching experience indicate: elementary, secondary, normal college, nursing, or other.\nHave you taught Red Cross Home Nursing (formerly Home Hygiene and Care of the Sick)?\nChapter\nCity and State\nType Groups\nDates\nV. EMPLOYMENT BASIS\n1. Type of work preferred: Rural\nUrban\nWill you accept either? Yes.\n2. What State or localities do you prefer? any\n3. When will you be available?\nat.\nonco\n4. Can you drive a car?\n5. What dependents or family responsibilities do you have?\nyes\nDo you own a car? no\nnone\n6.\nName of nearest relative to be notified in case of accident (relationship and address)\nWm.J. Connor. -Santa Moniga California\n7.\n8. May we approach your present employer for references? yes\nGive name of placement service, if registered, Mrsh Sullivan's with one Miss Regle Reg/+\n10. 9. When Do you did have you good have health? your last Yes. physical examination? June. 1942\nRemarks:\n(Please attach photograph\nof yourself, taken within\nthe past two years.)\nLikely L. of applicant) Channore\n(Signature\nDate"
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