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Form 1045-B
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE, PRESIDENT
JOHN BARTON PAYNE CHAIRMAN
ROBERT w. DE FOREST. Vice PRESIDENT
MRS AUGUST BELMONT
WILLIAM HOWARD TAFT, Vice PRESIDENT
THE AMERICAN RED CROSS
CORNELIUS N. BLISS
MABEL T. BOARDMAN
WILLIAM D. MITCHELL. COUNSELOR
MRS. HENRY P. DAVISON
OGDEN L. MILLS, TREASURER
NATIONAL HEADQUARTERS
E. B. DOUGLAS
I
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D.C.
HERBERT HOOVER
MAJ. GEN M. w. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
&
OGDEN L. MILLS
WILLIAM D. MITCHELL
JOHN BARTON PAYNE, CHAIRMAN
ROBERT E. OLDS
JAMES L. FIESER, VICE CHAIRMAN
GUSTAVUS D. POPE
5
ERNEST P. BICKNELL, VICE CHAIRMAN
MRS. HENRY R. REA
FEB 1 4 1928
JOHN D. RYAN
GEORGE E. SCOTT
T
REAR ADMIRAL E. R. STITT
Dear Madam:
it
The National Committee on Red Cross Nursing Service requires us to submit,
a
annually, a list of all enrolled Red Cross Nurses with their latest addresses. We are
extremely anxious to make a very complete report and ask for your cooperation. Will
you kindly answer the following questions and return this form to me, in the enclosed
envelope, at the earliest possible date?
Your sincerely,
D
Clasa D. royes
National Director,
Red Cross Nursing Service
Name in full Heuemette Andersen shipley.
If married, give husband's name
Permanent address Sleathing Outairs
Probable address for the next year Benny illi
Albecto Can
Name and address of nearest relative or friend in United States, through whom you may
be communicated with in an emergency. (State relationship)
Indicate the type of work
you are now doing:
Lady Recept
K H. P. Hospital Benngille,
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? m
Have you ever been? no
U
Indicate present physical condition good
-
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
J
Badge No. 21789
Current date February 22nd 1928
8
NOTE-If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrolment will be annulled.
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"ocrText": "S\nForm 1045-B\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nCALVIN COOLIDGE, PRESIDENT\nJOHN BARTON PAYNE CHAIRMAN\nROBERT w. DE FOREST. Vice PRESIDENT\nMRS AUGUST BELMONT\nWILLIAM HOWARD TAFT, Vice PRESIDENT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL. COUNSELOR\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nE. B. DOUGLAS\nI\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nHERBERT HOOVER\nMAJ. GEN M. w. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\n&\nOGDEN L. MILLS\nWILLIAM D. MITCHELL\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT E. OLDS\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\n5\nERNEST P. BICKNELL, VICE CHAIRMAN\nMRS. HENRY R. REA\nFEB 1 4 1928\nJOHN D. RYAN\nGEORGE E. SCOTT\nT\nREAR ADMIRAL E. R. STITT\nDear Madam:\nit\nThe National Committee on Red Cross Nursing Service requires us to submit,\na\nannually, a list of all enrolled Red Cross Nurses with their latest addresses. We are\nextremely anxious to make a very complete report and ask for your cooperation. Will\nyou kindly answer the following questions and return this form to me, in the enclosed\nenvelope, at the earliest possible date?\nYour sincerely,\nD\nClasa D. royes\nNational Director,\nRed Cross Nursing Service\nName in full Heuemette Andersen shipley.\nIf married, give husband's name\nPermanent address Sleathing Outairs\nProbable address for the next year Benny illi\nAlbecto Can\nName and address of nearest relative or friend in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nIndicate the type of work\nyou are now doing:\nLady Recept\nK H. P. Hospital Benngille,\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? m\nHave you ever been? no\nU\nIndicate present physical condition good\n-\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nJ\nBadge No. 21789\nCurrent date February 22nd 1928\n8\nNOTE-If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}