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FORM NO. 1
AMERICAN RED CROSS
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
1. Name of applicant Jessie g Turnbull
Badge number.
2. Address in full millvale th of Friendship ave Pittsbregh Pa
3.
Date of birth way 6 1879 Place of birth
Monmouth Illinois
4.
Are you married, single of a widow? single
Are you a citizen of the United States?
yes
5. Have you any physical defects or tendency to constitutional, or pulmonary trouble? no
6. Name educational institutions attended before entering training school, stating number of years at each and
from which you were graduated The Illumons State normal
2 years Taughl eighth grade school
sex years
7. Occupation before entering training school teacher
8. From what hospital training school were you graduated? Give location of hospital and date of graduation
The University of Penna Praming School Pluladelphia. Ca
9. Character of hospital:
General
Special ?
Private ?
10. Daily average number of patients in hospital during training 325- - Length of course 3 yrs
yes
11. Name and address of superintendent of training school under whom you received training
(Uiss) Sydia a whitton meadville Pa -
12. Of what nursing organizations are you a member ? Alumin the university
Hospital Snawing school - Registered nurse in Perm
13.
Give name and address of secretary of at least one of these organizations.
unsts manie Rose She university 8 Perm Hosph
14. Are you a registered nurse ? yes In what state ? Peur Date of registration 1912
15. State how, where and for what period of time, in each instance, you have been employed since graduation,
half years or She university of Penna. Hospital
including present employment assh Directies 8 nuses-one and one
for nurser Pittobing Pa seven and one theif one years
in the wastern Penna Hospital Transing School
Puh of Training School and Directies 8 nurse
16. In the event of war are you willing to take the oath of allegiance
?
yes
17. Name and permanent address of nearest relative
Uus David a Sumbule monmouth Illinois
Date 4-17-1916
Signature Jeaser I and Jumbell endorsement by local Committee
This blank is to be sent to applicant with circular letter and rules governing enrollment. After approval
to be forwarded with " credentials" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c.
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Document data
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DTO data
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"ocrText": "FORM NO. 1\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\n1. Name of applicant Jessie g Turnbull\nBadge number.\n2. Address in full millvale th of Friendship ave Pittsbregh Pa\n3.\nDate of birth way 6 1879 Place of birth\nMonmouth Illinois\n4.\nAre you married, single of a widow? single\nAre you a citizen of the United States?\nyes\n5. Have you any physical defects or tendency to constitutional, or pulmonary trouble? no\n6. Name educational institutions attended before entering training school, stating number of years at each and\nfrom which you were graduated The Illumons State normal\n2 years Taughl eighth grade school\nsex years\n7. Occupation before entering training school teacher\n8. From what hospital training school were you graduated? Give location of hospital and date of graduation\nThe University of Penna Praming School Pluladelphia. Ca\n9. Character of hospital:\nGeneral\nSpecial ?\nPrivate ?\n10. Daily average number of patients in hospital during training 325- - Length of course 3 yrs\nyes\n11. Name and address of superintendent of training school under whom you received training\n(Uiss) Sydia a whitton meadville Pa -\n12. Of what nursing organizations are you a member ? Alumin the university\nHospital Snawing school - Registered nurse in Perm\n13.\nGive name and address of secretary of at least one of these organizations.\nunsts manie Rose She university 8 Perm Hosph\n14. Are you a registered nurse ? yes In what state ? Peur Date of registration 1912\n15. State how, where and for what period of time, in each instance, you have been employed since graduation,\nhalf years or She university of Penna. Hospital\nincluding present employment assh Directies 8 nuses-one and one\nfor nurser Pittobing Pa seven and one theif one years\nin the wastern Penna Hospital Transing School\nPuh of Training School and Directies 8 nurse\n16. In the event of war are you willing to take the oath of allegiance\n?\nyes\n17. Name and permanent address of nearest relative\nUus David a Sumbule monmouth Illinois\nDate 4-17-1916\nSignature Jeaser I and Jumbell endorsement by local Committee\nThis blank is to be sent to applicant with circular letter and rules governing enrollment. After approval\nto be forwarded with \" credentials\" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D. c."
}