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D. M.R.-I
AMERICAN RED CROSS
(CROIX-ROUGE AMÉRICAINE)
19
ÉLYSÉES 43-82
ADRESSE TÉLÉGRAPHIQUE :
"
43-83
TÉLÉPHONE
"
"
43-88
AMCROSS "
"
43-89
4, PLACE DE LA CONCORDE
NURSING SERVICE
Mrs.
PARIS,
a
APPLICATION FOR ENROLLMENT
the
E
(To be filled out entirely in applicant's handwriting and each question answered
viller fully) S
1. Name of applicant in full
Elsie Margnerite Jessup
2. Address in full, Street. Via di Cameratal City fluence,
State
Italy
3. Date of birth May 19, 1887.
Place of birth Easton, Pa u-sa
4. Are you married, single or a widow ?
Single
Are you a citizen of the United States ?
yes
7
M.
5. Have you any physical defects or tendency to constitutional or pulmonary trouble ?
no
Are you physically strong and healthy ?
yes
6. Name educational institutions attended before entering training school, stating number of years at each and from which you were graduated
Long Irland, graduated 1904 finm there.
Ecole Maret, Geneva Suitzerland 2 years. St many's School, Graden City
7. What languages other than English do you speak P french (fluently) Serbians Italian (slightly)
8. Occupation before entering training school
none
9. From what hospital training school did you receive your diploma ? new york Hospital sweetle street
City and
state new york City - n.4.
Date of graduation March, 1911
10. Character of hospital : General ? yes-
Special ?
Private ?
11. Did your training include obstetrics ? yes Care of men ? yes Children ? yes Contagious diseases ? he
12. Daily average number of patients in hospitals during training
250-300
Length
of course. 2 1/2 years
13. and school under whom received
Name address of superintendent of training you training His a Henderson (decead
14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each
15.
OF what nursing organizations are you a member ? new york Hospital alumal
16. Which, if any, is affiliated with the American Nurses Association ?
17. Give name and address of secretary of at least one of these organizations
18. Are you a registered nurse ? no
In what state ?
Date of registration
19. State how, where and for what period of time, in each instance, you have been employed since graduation, including present employment,
giving name and address of persons in charge Head nurse, male word. news york/trifal, 1 1/2 years,
District nurse, Grace Chapel, new york 1 year, American ambulance
Hospital,Neirly. have, Sept 1414-t gagen 1915. In charge, American mission
Zaitchar Sentra 10 months; Hopital Miletime 76s Ris Grangia, fraund,
Persa Italiana, floreme, Utaly since gec 2s, 1917
1 months (Cof. Kellow, chief) at present, Gredale Territoriall $10, (Gree
(Specify for which of the following services you wish to be considered.)
20. War service, wherever needed
yes
U.S. only
When available July,
Are you willing to take the oath of allegiance P
yes
21. Instructor, Elementary Hygiene
Home Dietetics
Surgical Dressings
22. Public Health Nursing in Town and Country Nursing Service
23.
Name
and
permanent address of nearest relative. mrs. argustus C. Jerrup (mother)
forest Hiels, hong island usa.
Date. feb 6, 1918
Signature
Elsit M. Jessup.
w
To the Committee :
This blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, and A. R. C. 150. Appli-
cation forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorsement by Local
Committee, with credentials (Forms 3 and 4) together with Forms 10 and 11, should be forwarded to the Chairman, National Committee on
N
Nursing Service, American Red Cross, Washington, D. C.
In case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local Committee,
instead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Committee, from whence credentials
will be procured.
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"ocrText": "D. M.R.-I\nAMERICAN RED CROSS\n(CROIX-ROUGE AMÉRICAINE)\n19\nÉLYSÉES 43-82\nADRESSE TÉLÉGRAPHIQUE :\n\"\n43-83\nTÉLÉPHONE\n\"\n\"\n43-88\nAMCROSS \"\n\"\n43-89\n4, PLACE DE LA CONCORDE\nNURSING SERVICE\nMrs.\nPARIS,\na\nAPPLICATION FOR ENROLLMENT\nthe\nE\n(To be filled out entirely in applicant's handwriting and each question answered\nviller fully) S\n1. Name of applicant in full\nElsie Margnerite Jessup\n2. Address in full, Street. Via di Cameratal City fluence,\nState\nItaly\n3. Date of birth May 19, 1887.\nPlace of birth Easton, Pa u-sa\n4. Are you married, single or a widow ?\nSingle\nAre you a citizen of the United States ?\nyes\n7\nM.\n5. Have you any physical defects or tendency to constitutional or pulmonary trouble ?\nno\nAre you physically strong and healthy ?\nyes\n6. Name educational institutions attended before entering training school, stating number of years at each and from which you were graduated\nLong Irland, graduated 1904 finm there.\nEcole Maret, Geneva Suitzerland 2 years. St many's School, Graden City\n7. What languages other than English do you speak P french (fluently) Serbians Italian (slightly)\n8. Occupation before entering training school\nnone\n9. From what hospital training school did you receive your diploma ? new york Hospital sweetle street\nCity and\nstate new york City - n.4.\nDate of graduation March, 1911\n10. Character of hospital : General ? yes-\nSpecial ?\nPrivate ?\n11. Did your training include obstetrics ? yes Care of men ? yes Children ? yes Contagious diseases ? he\n12. Daily average number of patients in hospitals during training\n250-300\nLength\nof course. 2 1/2 years\n13. and school under whom received\nName address of superintendent of training you training His a Henderson (decead\n14. If your training as a nurse was received in more than one hospital, give name, location and time spent in each\n15.\nOF what nursing organizations are you a member ? new york Hospital alumal\n16. Which, if any, is affiliated with the American Nurses Association ?\n17. Give name and address of secretary of at least one of these organizations\n18. Are you a registered nurse ? no\nIn what state ?\nDate of registration\n19. State how, where and for what period of time, in each instance, you have been employed since graduation, including present employment,\ngiving name and address of persons in charge Head nurse, male word. news york/trifal, 1 1/2 years,\nDistrict nurse, Grace Chapel, new york 1 year, American ambulance\nHospital,Neirly. have, Sept 1414-t gagen 1915. In charge, American mission\nZaitchar Sentra 10 months; Hopital Miletime 76s Ris Grangia, fraund,\nPersa Italiana, floreme, Utaly since gec 2s, 1917\n1 months (Cof. Kellow, chief) at present, Gredale Territoriall $10, (Gree\n(Specify for which of the following services you wish to be considered.)\n20. War service, wherever needed\nyes\nU.S. only\nWhen available July,\nAre you willing to take the oath of allegiance P\nyes\n21. Instructor, Elementary Hygiene\nHome Dietetics\nSurgical Dressings\n22. Public Health Nursing in Town and Country Nursing Service\n23.\nName\nand\npermanent address of nearest relative. mrs. argustus C. Jerrup (mother)\nforest Hiels, hong island usa.\nDate. feb 6, 1918\nSignature\nElsit M. Jessup.\nw\nTo the Committee :\nThis blank is to be sent to applicant with circular letter D. M. R. 7, together with Forms D. M. R. 2, 11, and A. R. C. 150. Appli-\ncation forms (except of a nurse desiring to enroll for the Town and Country Nursing Service) after approval and endorsement by Local\nCommittee, with credentials (Forms 3 and 4) together with Forms 10 and 11, should be forwarded to the Chairman, National Committee on\nN\nNursing Service, American Red Cross, Washington, D. C.\nIn case the application forms of a nurse desiring to enroll for the Town and Country Nursing Service are sent to the Local Committee,\ninstead of to Washington, as instructed, such forms should be forwarded at once to Washington by the Local Committee, from whence credentials\nwill be procured."
}