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AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
I. Name of applicant miss margant a. stay effer
t
2. Address
120 3.40 East Witied Sti Buffalo My
A
3. Date of birth fan 11. 7.873 Place of birth Pare
4. Are you married, single or a widow ?
Sing le
5. you citizen of the United States? gen
Are a
6. Have you any physical defects? no.
7.
Education and occupation before entering Training School Prepared to enler
High school. Operator.
8.
From what Training School did you graduate? Buffate Womans Hospital
Buffalo newlyork
9. Character of hospital: General
Special?
Private? Surgical
IO. How many beds in hospital at time of graduation ?
35
II.
Date of graduation Sept: 80.. 190.8. Length of course
Thorey yeare
I2. Name and address of Superintendent of Training School under whom you were trained
Mm. Ha. D. Stick 1.91. Georgia St. Buffalo n.y.
13. Of what nursing organization are you a member ? Buff also Womans
Hospital alumnal.
14.
Give name and address of Secretary margaret Hoeminary 69.9. Ashdand are
15. Are you a registered nurse? no. In what State? -
Buffolo,wig.
Date of registration
16. How and where have you been employed since graduation? Give information for each year
Privale-mork in Buffalo and surrounding Jownsi
17. Name and permanent address of nearest relative Mrs m. Alice House
Signature many and a. JUD. E. litica st Biffers neys
Date Jan, 5-1911.
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Document data
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"ocrText": "ff\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nI. Name of applicant miss margant a. stay effer\nt\n2. Address\n120 3.40 East Witied Sti Buffalo My\nA\n3. Date of birth fan 11. 7.873 Place of birth Pare\n4. Are you married, single or a widow ?\nSing le\n5. you citizen of the United States? gen\nAre a\n6. Have you any physical defects? no.\n7.\nEducation and occupation before entering Training School Prepared to enler\nHigh school. Operator.\n8.\nFrom what Training School did you graduate? Buffate Womans Hospital\nBuffalo newlyork\n9. Character of hospital: General\nSpecial?\nPrivate? Surgical\nIO. How many beds in hospital at time of graduation ?\n35\nII.\nDate of graduation Sept: 80.. 190.8. Length of course\nThorey yeare\nI2. Name and address of Superintendent of Training School under whom you were trained\nMm. Ha. D. Stick 1.91. Georgia St. Buffalo n.y.\n13. Of what nursing organization are you a member ? Buff also Womans\nHospital alumnal.\n14.\nGive name and address of Secretary margaret Hoeminary 69.9. Ashdand are\n15. Are you a registered nurse? no. In what State? -\nBuffolo,wig.\nDate of registration\n16. How and where have you been employed since graduation? Give information for each year\nPrivale-mork in Buffalo and surrounding Jownsi\n17. Name and permanent address of nearest relative Mrs m. Alice House\nSignature many and a. JUD. E. litica st Biffers neys\nDate Jan, 5-1911."
}