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FORM 1045 REV. OCT. 1943 AMERICAN RED CROSS NURSING SERVICE ANNUAL QUESTIONNAIRE-1944 Red Cross If you have changed your last name Badge number 6072 since contacting us, please check here. office: STaTe 8883 Name in full Tittman , anna Louise Tel. No Home Whitehall (last) (first) (middle) If married, give maiden single name Date of birth 1884 4245 Marital status single Husband's name (single, married, widowed, divorced) Permanent address R.J.Travis - 312 W. 114th St Chicago, Cook Co Ills. (street) (city) (county) (state) Present address 25 Delaware P.I. Chicago, cook IIIS (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. R. J. Travis 3124 W. 114th St. Chicago Ills Niece (name) (address) Morgan Park station (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 Placemont Nurses Coursel ing Executive Director Nurse Placement Service 8 So. Michigan ave. Chicago Ills 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? and age (specify date) Not available, for the following reason? (specify) Do you have any dependents under 14 years age? Yes No 32/44 AVAILABILITY FOR SERVICE WITH CIVILIANS If qualified and not already doing so, will you be available: To teach Red Cross Home Nursing classes? To To teach volunteer nurse's aides? To take a Red Cross emergency assignment? 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 Cyclone Charleston fees. Drownings: - entimed Pience Pekin fees.

Page data

Page
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Source index
0
Type
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Media ID
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Document data

ID
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Core
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Type
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DTO data
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Context sent to Scholar

Document identity
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Document source extras
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Page context
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    "ocrText": "FORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nIf you have changed your last name\nBadge number 6072\nsince contacting us, please check here.\noffice: STaTe 8883\nName in full Tittman , anna Louise\nTel. No Home Whitehall\n(last)\n(first)\n(middle)\nIf married, give maiden single\nname\nDate of birth 1884\n4245\nMarital status\nsingle\nHusband's name\n(single, married, widowed, divorced)\nPermanent\naddress R.J.Travis - 312 W. 114th St\nChicago,\nCook\nCo\nIlls.\n(street)\n(city)\n(county)\n(state)\nPresent address 25 Delaware P.I. Chicago, cook\nIIIS\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. R. J. Travis\n3124 W. 114th St. Chicago Ills\nNiece\n(name)\n(address) Morgan Park station\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\nPlacemont Nurses Coursel ing\nExecutive Director Nurse Placement Service\n8 So. Michigan ave. Chicago Ills\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?\nand\nage\n(specify date)\nNot available, for the following reason?\n(specify)\nDo you have any dependents under 14 years age? Yes\nNo\n32/44\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes?\nTo\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf\nyes, specify type of disaster Cyclone Charleston fees.\nDrownings: - entimed Pience Pekin fees."
}