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Form 1082 AMERICAN NATIONAL RED CROSS Rev. 6-18-29 HOME HYGIENE AND CARE OF THE SICK SERVICE INSTRUCTOR'S APPLICATION Please fill out this form and RETURN TO Home Hygiene and Care of the Sick Service 1. PERSONNEL INFORMATION: Name in full Rosam. Schlodviler Red Cross Badge No. Pending Present address madison, ministora Date of birth Sept. 4,1900 Are you single, married, separated, widowed or divorced? Single State condition of health good If applying for a position state your preference and limitations as to locality am in Red Cross Public Health Service 2. PROFESSIONAL EDUCATION: Name of training school McKennan Hospital Location Scount Falls, S. Dak Date of graduation September 12,1924 Registration Minnerote bothDaeata 1926 1924 (State) (Year) Citizenship yes Postgraduate work University of Minnisota Public Health 1925 PASTERS (Hospital) (Types of work) (Date) summer sessions) If not an enrolled Red Cross nurse, have application papers been submitted to Local Red Cross Nursing Commi t tee? Due to physical dis ability several years ago, 2 was not eligible in 3. EDUCATION: Red Cross for for general general Service enrollment receiving only Home not information yet application sent Diplomas and Name and location Dates attending degrees rec'd. High school or equivalent madison Public School 1915-1919 Diploma Normal College Summer schools Special course in principles of teaching Did above course include practice teaching Do you hold a State teacher's certificate? In what State? PLEASE ANSWER QUESTIONS ON REVERSE SIDE 29666 OCT 28

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Document source extras
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Page context
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    "ocrText": "Form 1082\nAMERICAN NATIONAL RED CROSS\nRev. 6-18-29\nHOME HYGIENE AND CARE OF THE SICK SERVICE\nINSTRUCTOR'S APPLICATION\nPlease fill out this form\nand RETURN TO Home Hygiene and Care of the Sick Service\n1. PERSONNEL INFORMATION:\nName in full Rosam. Schlodviler\nRed Cross Badge No. Pending\nPresent address madison, ministora\nDate of birth Sept. 4,1900\nAre you single, married, separated, widowed or divorced? Single\nState condition of health good\nIf applying for a position state your preference and limitations as to locality\nam in Red Cross Public Health Service\n2. PROFESSIONAL EDUCATION:\nName of training school McKennan Hospital\nLocation Scount Falls, S. Dak Date of graduation September 12,1924\nRegistration Minnerote bothDaeata\n1926\n1924\n(State)\n(Year)\nCitizenship yes\nPostgraduate work University of Minnisota\nPublic Health\n1925\nPASTERS\n(Hospital)\n(Types of work)\n(Date) summer sessions)\nIf not an enrolled Red Cross nurse, have application papers been submitted to Local\nRed Cross Nursing Commi t tee? Due to physical dis ability several years ago, 2 was not eligible\nin\n3. EDUCATION:\nRed Cross for for general general Service enrollment receiving only Home not information yet application sent\nDiplomas and\nName and location\nDates attending degrees rec'd.\nHigh school\nor equivalent madison Public School\n1915-1919 Diploma\nNormal\nCollege\nSummer schools\nSpecial course in\nprinciples of teaching\nDid above course include practice teaching\nDo you hold a State teacher's certificate?\nIn what State?\nPLEASE ANSWER QUESTIONS ON REVERSE SIDE\n29666\nOCT 28"
}