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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 Darsy Dean Urch
Badge number
2. Address in full 502 S. Tremont St., Kewanee see
38+ 3. Date of birth June 9, 1876
Place of birth Clarkaston mich
4. Are you married, single or 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 Clarkston public school until aged 17 yrs,
Kindergartin Dept of Ferris Institute two years gradu-
ated Jim 1901.
7.
Occupation before entering training school Public school teacher
8. From what hospital training school were you graduated? Give location of hospital and date of graduation
Illinois Training School for nurses, Chicago, all. 1918.
9. Character of hospital: General
Special ?
Private?
10. Daily average number of patients in hospital during training 1500
Length of course 3 years. .
11. Name and address of superintendent of training school under whom you received training
Helen Scott Hay now with Red Cross in Europe
12. Of what nursing organizations are you a member ?
alumnia unaveration of Illnois Liaming Se. polluses
13. Give name and address of secretary of at least one of these organizations
Mrs C. S. Westcott 760 E 58th St., Chicago, all
14. Are you a registered nurse ? yes
In what state ? Illinois Date of
registration
$1/191
15. State how, where and for what period of time, in each instance, you have been employed since graduation,
including
present employment Private duty nursing in Chicago
since October 1913 when 9 finished my training
now doing private nursing
16. 17. In Name the event and of war are address you willing of nearest to take relative the oath Mrs. of allegiance Martin ? yes 7. Poole
permanent
Holly, Oukland County mich " Sister.
Date September 21, 1914
Signature Daisy D. Usels
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.
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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 Darsy Dean Urch\nBadge number\n2. Address in full 502 S. Tremont St., Kewanee see\n38+ 3. Date of birth June 9, 1876\nPlace of birth Clarkaston mich\n4. Are you married, single or a widow? Single Are you a citizen of the United States? Yes\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 Clarkston public school until aged 17 yrs,\nKindergartin Dept of Ferris Institute two years gradu-\nated Jim 1901.\n7.\nOccupation before entering training school Public school teacher\n8. From what hospital training school were you graduated? Give location of hospital and date of graduation\nIllinois Training School for nurses, Chicago, all. 1918.\n9. Character of hospital: General\nSpecial ?\nPrivate?\n10. Daily average number of patients in hospital during training 1500\nLength of course 3 years. .\n11. Name and address of superintendent of training school under whom you received training\nHelen Scott Hay now with Red Cross in Europe\n12. Of what nursing organizations are you a member ?\nalumnia unaveration of Illnois Liaming Se. polluses\n13. Give name and address of secretary of at least one of these organizations\nMrs C. S. Westcott 760 E 58th St., Chicago, all\n14. Are you a registered nurse ? yes\nIn what state ? Illinois Date of\nregistration\n$1/191\n15. State how, where and for what period of time, in each instance, you have been employed since graduation,\nincluding\npresent employment Private duty nursing in Chicago\nsince October 1913 when 9 finished my training\nnow doing private nursing\n16. 17. In Name the event and of war are address you willing of nearest to take relative the oath Mrs. of allegiance Martin ? yes 7. Poole\npermanent\nHolly, Oukland County mich \" Sister.\nDate September 21, 1914\nSignature Daisy D. Usels\nThis blank is to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee\nto be forwarded with \"credentials\" (Forms Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, Washington, D.C."
}