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FORM 1045--REV. 2-24-27
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
MRS. AUGUST BELMONT
ROBERT w. DE FOREST. VICE PRESIDENT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT, VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
WILLIAM D. MITCHELL. COUNSELOR
J. REUBEN CLARK, JR.
OGDEN L. MILLS, TREASURER
NATIONAL HEADQUARTERS
MRS. HENRY P. DAVISON
E.B. DOUGLAS
MABEL T. BOARDMAN, SECRETARY
WASHINGTON, D.C.
MRS FRANK v. HAMMAR
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
JOHN BARTON PAYNE, CHAIRMAN
1930
WILLIAM D. MITCHELL
GUSTAVUS D. POPE
JAMES L. FIESER, VICE CHAIRMAN
MRS HENRY R. REA
REAR ADMIRAL CHARLES E. RIGGS
ERNEST P. BICKNELL, VICE CHAIRMAN
JOHN D, RYAN
GEORGE E, SCOTT
Miss Emily H. Smith,
315 Prospect Avenue,
Ingram, Pennsylvania.
Crafton P.O.
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask for your cooperation. Please answer the following questions and
return this form to me, in the enclosed envelope, at the earliest possible date.
IMPORTANT:
In order to render prompt service
Yours sincerely,
in time of disaster, enrolled Red Cross
T Elnes Suitten
Chairman or
nurses should report at once to the
Secretary.
Secretary of the Local Committee under
which they are enrolled. Do not forget
Pittsburgh
Local Committee.
the address of the Secretary.
Name in full
Euily Hawmand Dinich
If married, give husband's name
Permanent address
315 Prospect ave Ingram Pa Ciaglon P.O.
Probable address for the next year
same
Telephone No. Walnut 0246
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been? yes
Indicate present physical condition Excellent
no
Would you respond to an emergency call in event of epidemic, disaster, war, etc.' ?
Badge No. #13,377
Current date Jany 28. 1930
NOTE.-- If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrollment will be annulled.
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"ocrText": "FORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. AUGUST BELMONT\nROBERT w. DE FOREST. VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT, VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL. COUNSELOR\nJ. REUBEN CLARK, JR.\nOGDEN L. MILLS, TREASURER\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nE.B. DOUGLAS\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D.C.\nMRS FRANK v. HAMMAR\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nJOHN BARTON PAYNE, CHAIRMAN\n1930\nWILLIAM D. MITCHELL\nGUSTAVUS D. POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL, VICE CHAIRMAN\nJOHN D, RYAN\nGEORGE E, SCOTT\nMiss Emily H. Smith,\n315 Prospect Avenue,\nIngram, Pennsylvania.\nCrafton P.O.\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nT Elnes Suitten\nChairman or\nnurses should report at once to the\nSecretary.\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nPittsburgh\nLocal Committee.\nthe address of the Secretary.\nName in full\nEuily Hawmand Dinich\nIf married, give husband's name\nPermanent address\n315 Prospect ave Ingram Pa Ciaglon P.O.\nProbable address for the next year\nsame\nTelephone No. Walnut 0246\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? yes\nIndicate present physical condition Excellent\nno\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.' ?\nBadge No. #13,377\nCurrent date Jany 28. 1930\nNOTE.-- If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}