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FORM 1045--REV. 2-24-27
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE, 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
HERBERT HOOVER
MAJ. GEN. M. W. IRELAND
NATIONAL EXECUTIVE OFFICERS
SAMUEL KNIGHT
JOHN BARTON PAYNE. CHAIRMAN
APR 1929
OGDEN L. MILLS
WILLIAM D. MITCHELL
JAMES L. FIESER, VICE CHAIRMAN
GUSTAVUS D. POPE
MRS. HENRY R. REA
ERNEST P. BICKNELL. VICE CHAIRMAN
REAR ADMIRAL CHARLES E. RIGGS
JOHN D. RYAN
GEORGE E. SCOTT
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, ANNA ROGERS
in time of disaster, enrolled Red Cross
Chairman or
nurses should report at once to the
AMERICAN RED CROSSeretary.
Secretary of the Local Committee under
1610 Locust Street,
which they are enrolled. Do not forget
PHILADELPHIA, :-: PA.
Local Committee.
the address of the Secretary
Name in full
Enities tryin
If married, give husband's name
Permanent address H400 Ballume are Phila - Pa -
Probable address for the next year
same
Telephone No. Bar-256le
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency (State relationship)
none
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?
Mo
Indicate present physical condition
bood
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Badge No. m392
Current date
affiliation
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\nCALVIN COOLIDGE, 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\nHERBERT HOOVER\nMAJ. GEN. M. W. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nSAMUEL KNIGHT\nJOHN BARTON PAYNE. CHAIRMAN\nAPR 1929\nOGDEN L. MILLS\nWILLIAM D. MITCHELL\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN D. RYAN\nGEORGE E. SCOTT\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, ANNA ROGERS\nin time of disaster, enrolled Red Cross\nChairman or\nnurses should report at once to the\nAMERICAN RED CROSSeretary.\nSecretary of the Local Committee under\n1610 Locust Street,\nwhich they are enrolled. Do not forget\nPHILADELPHIA, :-: PA.\nLocal Committee.\nthe address of the Secretary\nName in full\nEnities tryin\nIf married, give husband's name\nPermanent address H400 Ballume are Phila - Pa -\nProbable address for the next year\nsame\nTelephone No. Bar-256le\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency (State relationship)\nnone\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?\nMo\nIndicate present physical condition\nbood\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. m392\nCurrent date\naffiliation\nNOTE. - If the nurse does not complete and return this questionnaIre, and can not\nbe located within two years, her enrollment will be annulled."
}