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FORM 1045--REV. 2-24-27
a
NATIONAL OFFICERS
CENTRAL COMMITTEE
JOHN BARTON PAYNE, CHAIRMAN
CALVIN COOLIDGE. PRESIDENT
MRS, AUGUST BELMONT
ROBERT w. DE FOREST, VICE PRESIDENT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
MRS. HENRY P. DAVISON
WILLIAM D. MITCHELL, COUNSELOR
NATIONAL HEADQUARTERS
CHARLES s. DEWEY
CHARLES s. DEWEY, TREASURER
E.B. DOUGLAS
MABEL T. BOARDMAN. SECRETARY
WASHINGTON. D.C.
JOSEPH c. GREW
MRS. FRANK v. HAMMAR
HERBERT HOOVER
MAJ. GEN. M. w. IRELAND
NATIONAL EXECUTIVE OFFICERS
WILLIAM D. MITCHELL
w. w. MORROW
JOHN BARTON PAYNE, CHAIRMAN
GUSTAVUS D. POPE
JAMES L. FIESER, VICE CHAIRMAN
MRS. HENRY R. REA
ERNEST P. BICKNELL. VICE CHAIRMAN
JOHN D. RYAN
GEORGE E. SCOTT
REAR ADMIRAL E. R. STITT
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all the Red Cross Nurses enrolled with our Committee, with their
latest addresses. We are extremely anxious to make a very complete report to National
Headquarters and ask. for your cooperation. Please answer the following questions and
return this form to me, in the enclosed envelope, at the earliest possible date.
IMPORTANT:
Yours sincerely,
In order to render prompt service
Chairman or
FLORENCE M. JOHNSUN
in time of disaster, enrolled Red Cross
Secretary.
nurses should report at once to the
MANHATTAN
Secretary of the Local Committee under
Local Committee.
which they are enrolled. Do not forget
the address of the Secretary.
Caroline a beaver
Name in full
If married, give husband's name
Permanent address
A 8/ = - newyorl
6
Probable address for the next year
Telephone No. Caledonia 3639
Name and address of nearest relative or friend, in United
through whom you may
be communicated with in an emergency. (State relationship)
A mm drauklin Baha. Bryn mauor Penna
(Sister)
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no
Have you ever been? no
Indicate present physical condition Jair
-
Would you respond to an emergency call in event of epidemic, disaster, war, etc. possible to
not -
Badge No. 21836
Current date april 2. 28
NOTE.--If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrollment will be annulled.
21,
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"ocrText": "FORM 1045--REV. 2-24-27\na\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. PRESIDENT\nMRS, AUGUST BELMONT\nROBERT w. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nMRS. HENRY P. DAVISON\nWILLIAM D. MITCHELL, COUNSELOR\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\nCHARLES s. DEWEY, TREASURER\nE.B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D.C.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nMAJ. GEN. M. w. IRELAND\nNATIONAL EXECUTIVE OFFICERS\nWILLIAM D. MITCHELL\nw. w. MORROW\nJOHN BARTON PAYNE, CHAIRMAN\nGUSTAVUS D. POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nREAR ADMIRAL E. R. STITT\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all the Red Cross Nurses enrolled with our Committee, with their\nlatest addresses. We are extremely anxious to make a very complete report to National\nHeadquarters and ask. for your cooperation. Please answer the following questions and\nreturn this form to me, in the enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nChairman or\nFLORENCE M. JOHNSUN\nin time of disaster, enrolled Red Cross\nSecretary.\nnurses should report at once to the\nMANHATTAN\nSecretary of the Local Committee under\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nCaroline a beaver\nName in full\nIf married, give husband's name\nPermanent address\nA 8/ = - newyorl\n6\nProbable address for the next year\nTelephone No. Caledonia 3639\nName and address of nearest relative or friend, in United\nthrough whom you may\nbe communicated with in an emergency. (State relationship)\nA mm drauklin Baha. Bryn mauor Penna\n(Sister)\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nHave you ever been? no\nIndicate present physical condition Jair\n-\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. possible to\nnot -\nBadge No. 21836\nCurrent date april 2. 28\nNOTE.--If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled.\n21,"
}