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S
a
F
FORM 1045
REV. OCT. 1943
9
AMERICAN RED CROSS
T
on
NURSING SERVICE
a
ANNUAL QUESTIONNAIRE-1944
10)
Red Cross
Badge number 72465
If you have changed your last name
since contacting us, please check here.
Name in full Jullivan T Fara
(last)
C
Tel. No. Wah. 6425
(first)
(middle)
If married, give maiden name
Marital status Single
Date of birth July 10, 1916
Husband's name
(single, (married, widowed, divorced)
Permanent address 1209 East 11th Shawner
Pottaurtomic
(street)
1
Oklahoma
(city)
(county)
(state)
Present address 830-a (street) California Wahiewa Honolulu 1
Oahu T.H.
(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:
mr.trrs P. L Sullivan- East 11th Shawnes, Oklahoma - Parents
(name)
(address)
(relationship)
Are you employed in nursing at the present time? Yes
No
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
Surgical nurst at the Wahiawa Emergency Hospital
Wahiawa, Odhu, T.H.
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:
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason? Was employed forthis place (specify) byths am.R.C of switched
to the C.D.
-
Do you have any dependents under 14 years of age? Yes
No
would like to it it
AVAILABILITY FOR SERVICE WITH CIVILIANS
through.
If qualified and not already doing so, will you be available:
To teach Red Cross Home Nursing classes
To teach volunteer nurse's aides?
California
To take a Red Cross emergency assignment?
Have you ever served with the Red Cross in a disaster? Yes
To serve overseas caring for civilians ? This is what I am doing now
No
If yes, specify type of disaster l Unless was on you the Red call Cross coming paynoll into for here 6 months. after the Blitz a disaster.
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Document data
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"ocrText": "S\na\nF\nFORM 1045\nREV. OCT. 1943\n9\nAMERICAN RED CROSS\nT\non\nNURSING SERVICE\na\nANNUAL QUESTIONNAIRE-1944\n10)\nRed Cross\nBadge number 72465\nIf you have changed your last name\nsince contacting us, please check here.\nName in full Jullivan T Fara\n(last)\nC\nTel. No. Wah. 6425\n(first)\n(middle)\nIf married, give maiden name\nMarital status Single\nDate of birth July 10, 1916\nHusband's name\n(single, (married, widowed, divorced)\nPermanent address 1209 East 11th Shawner\nPottaurtomic\n(street)\n1\nOklahoma\n(city)\n(county)\n(state)\nPresent address 830-a (street) California Wahiewa Honolulu 1\nOahu T.H.\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:\nmr.trrs P. L Sullivan- East 11th Shawnes, Oklahoma - Parents\n(name)\n(address)\n(relationship)\nAre you employed in nursing at the present time? Yes\nNo\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\nSurgical nurst at the Wahiawa Emergency Hospital\nWahiawa, Odhu, T.H.\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:\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason? Was employed forthis place (specify) byths am.R.C of switched\nto the C.D.\n-\nDo you have any dependents under 14 years of age? Yes\nNo\nwould like to it it\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nthrough.\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes\nTo teach volunteer nurse's aides?\nCalifornia\nTo take a Red Cross emergency assignment?\nHave you ever served with the Red Cross in a disaster? Yes\nTo serve overseas caring for civilians ? This is what I am doing now\nNo\nIf yes, specify type of disaster l Unless was on you the Red call Cross coming paynoll into for here 6 months. after the Blitz a disaster."
}