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in L No. 1 RECEIVED AMERICAN RED CROSS () NURSING SERVICE APR -4 1912 APPLICATION FOR ENROLLMENT BY RED CROSS (To be filled out entirely in applicant's handwriting) Name of applicant Charture Elizabeth Van Duzor Badge Number 0 $ I. 2. Address in full 4. Are you married, single or a widow ? lingle Are you a citizen of the United States? yes 3. Date of birth Jan. 6" 1881 Place of birth Litchfield Penns 37 East 71 sheeT, New York City 5. Have you any physical defects? none 7. From what Training School did you graduate Rastyterinin Date May 18 1911 6. Occupation before entering Training School Private Secretary 8. Give location of Training School. 33.7.7.11 sheet 9. Character of hospital: General Several Special? - Private? - IO. How many beds at time of graduation? 250 Length of course Three years II. Name and address of Superintendent of Training School under whom you were trained anna C. Martweel, 3.7 East 71 Sheet new you I2. Of what nursing organizations are you a member? Alumnae am of I3. Give name and address of Secretary Miss Jan Seena, 404 N. 116 it Probley terian Hospital Newyork Cata 14. Are you a registered nurse? yes In what State NewYork Date of registration Oct.4"911 I5. How and where have you been employed since graduation? Give information for each year Organized School Inspection in Naterlown n.y 16. In the event of war are you willing to take the required oath of allegiance? vs 17. Name and permanent address of nearest relative. J H. Van Dagon (Brother) aTheus Peem Date March 4"1912 Signature Van rajor Committee to be forwarded with credentials" (Form Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service, This blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Washington, D. C.

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Page context
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    "ocrText": "in\nL\nNo. 1\nRECEIVED\nAMERICAN RED CROSS\n()\nNURSING SERVICE\nAPR -4 1912\nAPPLICATION FOR ENROLLMENT\nBY RED CROSS\n(To be filled out entirely in applicant's handwriting)\nName of applicant Charture Elizabeth Van Duzor Badge Number\n0 $\nI.\n2. Address in full\n4. Are you married, single or a widow ? lingle Are you a citizen of the United States? yes\n3. Date of birth Jan. 6\" 1881 Place of birth Litchfield Penns\n37 East 71 sheeT, New York City\n5. Have you any physical defects? none\n7. From what Training School did you graduate Rastyterinin Date May 18 1911\n6. Occupation before entering Training School Private Secretary\n8. Give location of Training School. 33.7.7.11 sheet\n9.\nCharacter of hospital: General Several Special? -\nPrivate? -\nIO. How many beds at time of graduation? 250 Length of course Three years\nII. Name and address of Superintendent of Training School under whom you were trained\nanna C. Martweel, 3.7 East 71 Sheet new you\nI2. Of what nursing organizations are you a member? Alumnae am of\nI3. Give name and address of Secretary Miss Jan Seena, 404 N. 116 it\nProbley terian Hospital\nNewyork Cata\n14. Are you\na registered nurse? yes In what State NewYork Date of registration Oct.4\"911\nI5. How and where have you been employed since graduation? Give information for each year\nOrganized School Inspection in Naterlown n.y\n16. In the event of war are you willing to take the required oath of allegiance? vs\n17. Name and permanent address of nearest relative. J H. Van Dagon (Brother)\naTheus Peem\nDate March 4\"1912\nSignature Van rajor\nCommittee to be forwarded with credentials\" (Form Nos. 3 and 4) to the Chairman, National Committee on Red Cross Nursing Service,\nThis blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local\nWashington, D. C."
}