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B.14.55
Lakeward
FORM NO. 1
us
AMERICAN RED CROSS
A
NURSING SERVICE
APPLICATION FOR ENROLLMENT
Z
(To be filled out entirely in applicant's handwriting)
a
1. Name of applicant
nathalic C Rudd R.N Badge number
+
2.
Address in full 40 Florence are norwood mass I
42+ 3.
Date of birth
Jan 9.1874
Place
of birth Chelsea. man
4.
Are you married, single or widow?
Are you a citizen of the United States?
5. Have you any physical defects or tendency to constitutional or pulmonary trouble?
no
6. Name educational institutions attended before entering training school, stating number of years at each and
from
which you were graduated Chelsea Sammar and)H igh Schiole
brad. 1888
Sad. 1892
Bryant Stratters Comm. School. left to Jan 1892-3
7. Occupation before entering training school
Stenographer (13yrs )
8.
From what hospital training school were you graduated? Give location of hospital and date of graduation
massachusetts General Hospital Bostin - Sept.1910
9. Character of hospital: General
Special?
.Privato ?
10. Daily average number of patients in hospital during training 300
Length of course
3 yrs
11.
Name and address of superintendent of training school under whom you received training
miss Para Parsons marsachustts General Hespital
12.
Of what nursing organizations are you a member ? m. G.H. hurres alumna ass n
Industrial music club, Boston St. Bamatas build for huren
13. Give name and address of secretary of at least one
of these organizations min Edna Harrison
Securatory m.g.H. nurses alumne asi n
14. Are you a registered nurse ?
yrs In what state ? mass Date of registration Feb.28,1911
15. State how, where and for what period of time, in each instance, you have been employed since graduation,
including present employment
with Plimptin Press, normal mass. in capacity
of Industrial nume since Jeb 1911.
16. In the event of war are you willing to take the oath of allegiance ?
yes
2
17. Name and permanent address of nearest relative mr. aller J. Rudd.
Chelsea Savings Bank, Chekea man
Date
3 - 6 - 16
Signature
nithatic Rudd R.N.
This blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee
to be forwarded with credentials (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c.
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"ocrText": "B.14.55\nLakeward\nFORM NO. 1\nus\nAMERICAN RED CROSS\nA\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\nZ\n(To be filled out entirely in applicant's handwriting)\na\n1. Name of applicant\nnathalic C Rudd R.N Badge number\n+\n2.\nAddress in full 40 Florence are norwood mass I\n42+ 3.\nDate of birth\nJan 9.1874\nPlace\nof birth Chelsea. man\n4.\nAre you married, single or widow?\nAre you a citizen of the United States?\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble?\nno\n6. Name educational institutions attended before entering training school, stating number of years at each and\nfrom\nwhich you were graduated Chelsea Sammar and)H igh Schiole\nbrad. 1888\nSad. 1892\nBryant Stratters Comm. School. left to Jan 1892-3\n7. Occupation before entering training school\nStenographer (13yrs )\n8.\nFrom what hospital training school were you graduated? Give location of hospital and date of graduation\nmassachusetts General Hospital Bostin - Sept.1910\n9. Character of hospital: General\nSpecial?\n.Privato ?\n10. Daily average number of patients in hospital during training 300\nLength of course\n3 yrs\n11.\nName and address of superintendent of training school under whom you received training\nmiss Para Parsons marsachustts General Hespital\n12.\nOf what nursing organizations are you a member ? m. G.H. hurres alumna ass n\nIndustrial music club, Boston St. Bamatas build for huren\n13. Give name and address of secretary of at least one\nof these organizations min Edna Harrison\nSecuratory m.g.H. nurses alumne asi n\n14. Are you a registered nurse ?\nyrs In what state ? mass Date of registration Feb.28,1911\n15. State how, where and for what period of time, in each instance, you have been employed since graduation,\nincluding present employment\nwith Plimptin Press, normal mass. in capacity\nof Industrial nume since Jeb 1911.\n16. In the event of war are you willing to take the oath of allegiance ?\nyes\n2\n17. Name and permanent address of nearest relative mr. aller J. Rudd.\nChelsea Savings Bank, Chekea man\nDate\n3 - 6 - 16\nSignature\nnithatic Rudd R.N.\nThis blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee\nto be forwarded with credentials (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c."
}