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FORM
1045
RECEIVE
REY. JAN 1941
AMERICAN RED CROSS
JUL 14 1941 UL 21 1941
NATIONAL HEADQUARTERS
Referred to
WASHINGTON. D. C.
Name in full Schladweiler
Rosa mani
Year of Birth Sept 4, 1900
(SURNAME)
(FIRST)
(MIDDLE)
Husband's name
Permanent address
(STREET)
madison (CITY) Sac Jui Carle (COUNTY) minnesota (STATE)
Probable address
for the next year
(STREET)
minneapolis (CITY) Hennifan (COUNTY) Minnesota (STATE)
Telephone number University (EXCHANGE) of minnesota (NO.)
Give name and address of nearest relative or friend in United States:
margaret (NAME) Schladwiler (RELATIONSHIP) (Sister)
madron minnesota
(ADDRESS)
PRESENT EMPLOYMENT (check below)
Name of agency or institution with which employed
Institutional
Public Health
Private duty
(homesing Consultant) american national Red Cross
Other (write in)
Government Service: Army
U.S.P.H. Service
Veterans Administration
Navy
U.S. Indian Service
Children's Bureau
MAJOR RESPONSIBILITIES Adminis-
Super
Teach-
General
Private
Other
of present employment tration
vision
ing
Staff
Duty
(specify)
IF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:
Institutional
Public Health
Private duty
Other
(WRITE IN)
AVAILABILITY
At the present time would you
Date
accept assignment to the Army? Yes
No
Navy? Yes
No
available
any
time
(Beyond age limit)
In case of a war emergency would you
accept assignment to the Army? Yes
No
Navy? Yes
No
If not now employed would you
accept nursing work? Full-time? Yes
No
Part-time? Yes
No
In your own community? Yes
No
Elsewhere? Yes
No
Would be interested in classes Home
you teaching in Hygiene and Care of the Sick? yes
Present physical condition Excellent
Badge No. 49,263
will
Current date July 17,1941
Name of Committee
NATIONAL HEADQUARTERS
Note: If a nurse does not complete and return this questionnaire, and cannot be located
within two years, her enrollment will be removed from our active files.
Page data
- Page
- 21
- Source index
- 0
- Type
- photo
- Media ID
- 73dff728173127a1
- Size
- unknown
Document data
- ID
- 2662227
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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"naId": 2662227,
"coverageEndDate": {
"day": 13,
"logicalDate": "1945-08-13",
"month": 8,
"year": 1945
},
"coverageStartDate": {
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"logicalDate": "1929-07-02",
"month": 7,
"year": 1929
},
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Page context
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"ocrText": "FORM\n1045\nRECEIVE\nREY. JAN 1941\nAMERICAN RED CROSS\nJUL 14 1941 UL 21 1941\nNATIONAL HEADQUARTERS\nReferred to\nWASHINGTON. D. C.\nName in full Schladweiler\nRosa mani\nYear of Birth Sept 4, 1900\n(SURNAME)\n(FIRST)\n(MIDDLE)\nHusband's name\nPermanent address\n(STREET)\nmadison (CITY) Sac Jui Carle (COUNTY) minnesota (STATE)\nProbable address\nfor the next year\n(STREET)\nminneapolis (CITY) Hennifan (COUNTY) Minnesota (STATE)\nTelephone number University (EXCHANGE) of minnesota (NO.)\nGive name and address of nearest relative or friend in United States:\nmargaret (NAME) Schladwiler (RELATIONSHIP) (Sister)\nmadron minnesota\n(ADDRESS)\nPRESENT EMPLOYMENT (check below)\nName of agency or institution with which employed\nInstitutional\nPublic Health\nPrivate duty\n(homesing Consultant) american national Red Cross\nOther (write in)\nGovernment Service: Army\nU.S.P.H. Service\nVeterans Administration\nNavy\nU.S. Indian Service\nChildren's Bureau\nMAJOR RESPONSIBILITIES Adminis-\nSuper\nTeach-\nGeneral\nPrivate\nOther\nof present employment tration\nvision\ning\nStaff\nDuty\n(specify)\nIF NOT EMPLOYED IN NURSING check field of nursing with which you are most familiar:\nInstitutional\nPublic Health\nPrivate duty\nOther\n(WRITE IN)\nAVAILABILITY\nAt the present time would you\nDate\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\navailable\nany\ntime\n(Beyond age limit)\nIn case of a war emergency would you\naccept assignment to the Army? Yes\nNo\nNavy? Yes\nNo\nIf not now employed would you\naccept nursing work? Full-time? Yes\nNo\nPart-time? Yes\nNo\nIn your own community? Yes\nNo\nElsewhere? Yes\nNo\nWould be interested in classes Home\nyou teaching in Hygiene and Care of the Sick? yes\nPresent physical condition Excellent\nBadge No. 49,263\nwill\nCurrent date July 17,1941\nName of Committee\nNATIONAL HEADQUARTERS\nNote: If a nurse does not complete and return this questionnaire, and cannot be located\nwithin two years, her enrollment will be removed from our active files."
}