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FORM NO. 1
AMERICAN RED CROSS
+
NURSING SERVICE
APPLICATION FOR ENROLLMENT
(To be filled out entirely in applicant's handwriting)
Sara Bickell
1. Name of applicant
Badge number
2. Address in full
3. Date of birth Sept. 11 th 1878 Place of birth Brooklin, Canada
Junedo Hospital Lunedo out. n.y.
4. Are you married, single or a widow? single Are you a citizen of the United States? no no
5. Have you any physical defects or tendency to constitutional or pulmonary trouble?
6. Name educational institutions attended before entering training school, stating number of years at each and
from
which you were graduated Public school - 8 yrs
High School yrs.
College for 3yrs
7. Occupation before entering training school
8. From what hospital training school were you graduated? Give location of hospital and date of graduation
Roosevelt Hospital- new york City 1907.
9. Character of hospital: General
X
Special ?
Private ?
10. Daily average number of patients in hospital during training 260. Length of course 3yrs.
11. Name and address of superintendent of training school under whom you received training
12. Of what nursing organizations are you a member ? Roosevelt of S. blummi
Miss Mary a. Samuel , Lakeside
and Ultistorio Graduate Murses
13. Give name and address of secretary of at least one of these organizations
miss Della Demmisors - - Roosevelt Hospital. n.ye
14. Are you a registered nurse ycs In what state ? bew York Date of registration 1907
15. State how, where and for what period of time, in each instance, you have been employed since graduation,
including present employment Did general private
from Ach. 1910 to now May 1914 have
sursing from March 1907 to clet 1910.
been Suprentendant of Yunedo Hospital
16. In the event of war are you willing to take the oath of allegiance ?
17. Name and permanent address of nearest relative sister Bickell
yes
181 Crescent Road Torouto-Canes
Date april 28 - the 1914 Signature Sarce a. Bickell:
This blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee
to
be forwarded with "credentials" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D.C.
Page data
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "FORM NO. 1\nAMERICAN RED CROSS\n+\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nSara Bickell\n1. Name of applicant\nBadge number\n2. Address in full\n3. Date of birth Sept. 11 th 1878 Place of birth Brooklin, Canada\nJunedo Hospital Lunedo out. n.y.\n4. Are you married, single or a widow? single Are you a citizen of the United States? no no\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble?\n6. Name educational institutions attended before entering training school, stating number of years at each and\nfrom\nwhich you were graduated Public school - 8 yrs\nHigh School yrs.\nCollege for 3yrs\n7. Occupation before entering training school\n8. From what hospital training school were you graduated? Give location of hospital and date of graduation\nRoosevelt Hospital- new york City 1907.\n9. Character of hospital: General\nX\nSpecial ?\nPrivate ?\n10. Daily average number of patients in hospital during training 260. Length of course 3yrs.\n11. Name and address of superintendent of training school under whom you received training\n12. Of what nursing organizations are you a member ? Roosevelt of S. blummi\nMiss Mary a. Samuel , Lakeside\nand Ultistorio Graduate Murses\n13. Give name and address of secretary of at least one of these organizations\nmiss Della Demmisors - - Roosevelt Hospital. n.ye\n14. Are you a registered nurse ycs In what state ? bew York Date of registration 1907\n15. State how, where and for what period of time, in each instance, you have been employed since graduation,\nincluding present employment Did general private\nfrom Ach. 1910 to now May 1914 have\nsursing from March 1907 to clet 1910.\nbeen Suprentendant of Yunedo Hospital\n16. In the event of war are you willing to take the oath of allegiance ?\n17. Name and permanent address of nearest relative sister Bickell\nyes\n181 Crescent Road Torouto-Canes\nDate april 28 - the 1914 Signature Sarce a. Bickell:\nThis blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee\nto\nbe forwarded with \"credentials\" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D.C."
}