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FORM 1045
OCT. 1943
AMERICAN RED CROSS
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
Red Cross
If you have changed your last name
Badge-number 79682
since contacting us, please check here.
Name in full STALL (last) JANeT (first) (middle) ElizABeth Tel. No.
6604z
e
If married, give maiden name
Date of birth MAR.13,1918
Marital status
Single
Husband's name
(single, married, widowed, divorced)
Permanent address 17EASTMAN (street) TeRRAce, (city) Poughkeepsie, (county) DuTChess (state) Co, New your
Present address 1742NUVANU AVE HoNolulu T.H.
(street)
(city)
(county)
(state)
Notify national headquarters immediately if you change your address.
Give name and address of nearest relative or friend in the United States:
MRS (name) WilliAM STALL , 1 E AST MAN (address) TeRRACe Pounheepsia Newyork
Are you employed in nursing at the present time Yes
No
(relationship) (Morber)
If employed, check the type of work you are doing and fill in below the title of your position and the name
and address of the agency or institution:
Institutional
Public Health
Industrial
Private Duty
Other
HeAD 1310 nuRse PunAhou Emer ST. geney. lulu Polio HOSPITAL
If not employed, what type of nursing would you prefer to render?
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you:
So
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason ? Serving with (specify) civilian unit
Do you have any dependents under 14 years of age Yes
No
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
No
To teach Red Cross Home Nursing classes?
To teach volunteer nurse's aides?
No
To take a Red Cross emergency assignment?
nD
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If yes, specify type of disaster
79682
Page data
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- Source index
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- Type
- photo
- Media ID
- 7db060f3e80626ef
- Size
- unknown
Document data
- ID
- 2662300
- Core
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- Type
- document
DTO data
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Context sent to Scholar
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Document source extras
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"ocrText": "cl\n9\nn\nFORM 1045\nOCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nIf you have changed your last name\nBadge-number 79682\nsince contacting us, please check here.\nName in full STALL (last) JANeT (first) (middle) ElizABeth Tel. No.\n6604z\ne\nIf married, give maiden name\nDate of birth MAR.13,1918\nMarital status\nSingle\nHusband's name\n(single, married, widowed, divorced)\nPermanent address 17EASTMAN (street) TeRRAce, (city) Poughkeepsie, (county) DuTChess (state) Co, New your\nPresent address 1742NUVANU AVE HoNolulu T.H.\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\nMRS (name) WilliAM STALL , 1 E AST MAN (address) TeRRACe Pounheepsia Newyork\nAre you employed in nursing at the present time Yes\nNo\n(relationship) (Morber)\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nHeAD 1310 nuRse PunAhou Emer ST. geney. lulu Polio HOSPITAL\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you:\nSo\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ? Serving with (specify) civilian unit\nDo you have any dependents under 14 years of age Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nNo\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nNo\nTo take a Red Cross emergency assignment?\nnD\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster\n79682"
}