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Form 1045 Rev. 1-7-30 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER. 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 CALVIN COOLIDGE, VICE PRESIDENT JOSEPH P. COTTON CHARLES EVANS HUGHES. JR.. COUNSELOR NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON OGDEN L. MILLS. TREASURER E. B. DOUGLAS WASHINGTON, D. C. MRS. FRANK v. HAMMAR MABEL T. BOARDMAN. SECRETARY CHARLES EVANS HUGHES, JR. MAJ. GEN. M. W. IRELAND SAMUEL KNIGHT NATIONAL EXECUTIVE OFFICERS OGDEN L. MILLS GUSTAVUS D. POPE JOHN BARTON PAYNE. CHAIRMAN MRS. HENRY R. REA JAMES L. FIESER, VICE CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS ERNEST P. BICKNELL. VICE CHAIRMAN JOHN D. RYAN GEORGE E. SCOTT JAMES K. MCCLINTOCK. VICE CHAIRMAN ELIOT WADSWORTH 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 enclosed envelope, at the earliest possible date. IMPORTANT: Yours sincerely, In order to render prompt service Chairman or ELLA E. McNEIL, R. N. in time of disaster, enrolled Red Cross 2100 DELANCEY STREET Secretary. nurses should report at once to the Secretary of the Local Committee under PHILADELPHIA, PENNA. Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full Juliet sayder If married, give husband's name Permanent address HAVO Pa (STREET, ETC.) (CITY) (COUNTY) (STATE) Probable address for the next year Same (STREET, ETC.) Tel ephone No. Bav-2566 (CITY) (COUNTY) (STATE) 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? Have you ever been? no Indicate present physical condition Hair - Would you respond to an emergency call in event of epidemic, disaster, war, etc.? yes Badge No. 23904 Current date March 71st-1930 NOTE.--I: 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": "Form 1045 Rev. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER. 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\nCALVIN COOLIDGE, VICE PRESIDENT\nJOSEPH P. COTTON\nCHARLES EVANS HUGHES. JR.. COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nOGDEN L. MILLS. TREASURER\nE. B. DOUGLAS\nWASHINGTON, D. C.\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN. SECRETARY\nCHARLES EVANS HUGHES, JR.\nMAJ. GEN. M. W. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE. CHAIRMAN\nMRS. HENRY R. REA\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nJAMES K. MCCLINTOCK. VICE CHAIRMAN\nELIOT WADSWORTH\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 enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nELLA E. McNEIL, R. N.\nin time of disaster, enrolled Red Cross\n2100 DELANCEY STREET\nSecretary.\nnurses should report at once to the\nSecretary of the Local Committee under\nPHILADELPHIA, PENNA.\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nJuliet sayder\nIf married, give husband's name\nPermanent address HAVO\nPa\n(STREET, ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nSame\n(STREET, ETC.)\nTel ephone No. Bav-2566\n(CITY)\n(COUNTY)\n(STATE)\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?\nHave you ever been?\nno\nIndicate present physical condition\nHair -\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nyes\nBadge No. 23904\nCurrent date\nMarch 71st-1930\nNOTE.--I: the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}