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+ FORM 1045--REV. 2-24-27 NATIONAL OFFICERS CENTRAL COMMITTEE JALVIN 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 CHARLES s. DEWEY, TREASURER NATIONAL HEADQUARTERS CHARLES s. DEWEY MABEL T. BOARDMAN. SECRETARY E, B. DOUGLAS WASHINGTON. D.C. JOSEPH c. GREW MRS. FRANK v. HAMMAR HERBERT HOOVER NATIONAL EXECUTIVE OFFICERS MAJ. GEN. M. w. IRELAND WILLIAM D. MITCHELL JOHN BARTON PAYNE, CHAIRMAN w.w. MORROW JAMES L. FIESER, VICE CHAIRMAN GUSTAVUS D. POPE ERNEST P BICKNELL. VICE CHAIRMAN MRS. HENRY R. REA JOHN D. RYAN GEORGE E. SCOTT REAR ADMIRAL E. R. STITT State and Local Committes Red Cross Nursing Service Providence, R. la 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: Yours sincerely, In order to render prompt service Chairman or in time of disaster, enrolled Red Cross MRS. PAUL APPLETON nurses should report at once to the Secretary. 35 Taber Ave. Secretary of the Local Committee under PROVIDENCE, R.L Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full adu H Staffant Permanent address 825 challestin are Prendume If married, give husband's name Probable address for the next year same R.l. Telephone No. GN1625 Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Rebecca a Stafford (sister ) 10 Barnes PN, Prendence Rd 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. Hospital Social service. Have you ever been? Are you instructor in Home Hygiene and Care of the Sick? yes an of Red Cross classes Indicate present physical condition Gord Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? Badge No. 29467 Current date 4-1-27 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": "+\nFORM 1045--REV. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nJALVIN 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\nCHARLES s. DEWEY, TREASURER\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nMABEL T. BOARDMAN. SECRETARY\nE, B. DOUGLAS\nWASHINGTON. D.C.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. M. w. IRELAND\nWILLIAM D. MITCHELL\nJOHN BARTON PAYNE, CHAIRMAN\nw.w. MORROW\nJAMES L. FIESER, VICE CHAIRMAN\nGUSTAVUS D. POPE\nERNEST P BICKNELL. VICE CHAIRMAN\nMRS. HENRY R. REA\nJOHN D. RYAN\nGEORGE E. SCOTT\nREAR ADMIRAL E. R. STITT\nState and Local Committes\nRed Cross Nursing Service\nProvidence, R. la\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:\nYours sincerely,\nIn order to render prompt service\nChairman or\nin time of disaster, enrolled Red Cross\nMRS. PAUL APPLETON\nnurses should report at once to the\nSecretary.\n35 Taber Ave.\nSecretary of the Local Committee under\nPROVIDENCE, R.L\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nadu H Staffant\nPermanent address 825 challestin are Prendume\nIf married, give husband's name\nProbable address for the next year same\nR.l.\nTelephone No. GN1625\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nRebecca a Stafford (sister ) 10 Barnes PN, Prendence Rd\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.\nHospital Social service.\nHave you ever been?\nAre you instructor in Home Hygiene and Care of the Sick? yes\nan of Red Cross classes\nIndicate present physical condition Gord\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ?\nBadge No. 29467\nCurrent date 4-1-27\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
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