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Form 1045 Rev. 1-7-30 NATIONAL OFFICERS CENTRAL COMMITTEE JOHN BARTON PAYNE, CHAIRMAN HERBERT HOOVER, 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 JOSEPH P. COTTON CALVIN COOLIDGE, VICE PRESIDENT MRS. HENRY P. DAVISON CHARLES EVANS HUGHES, JR,, COUNSELOR NATIONAL HEADQUARTERS E.B. DOUGLAS OGDEN L. MILLS, TREASURER MRS. FRANK v. HAMMAR WASHINGTON, D.C. CHARLES EVANS HUGHES, JR. 0 MABEL T. BOARDMAN. SECRETARY MAJ. GEN. M. w. IRELAND JOHN BARTON PAYNE, CHAIRMAN 34/2 for SAMUEL KNIGHT OGDEN L. MILLS S NATIONAL EXECUTIVE OFFICERS GUSTAVUS D. POPE MRS. HENRY R. REA REAR ADMIRAL CHARLES E. RIGGS 6 JAMES L. FIESER, VICE CHAIRMAN JOHN D. RYAN ERNEST P. BICKNELL, VICE CHAIRMAN GEORGE E, SCOTT ELIOT WADSWORTH JAMES K. McCLINTOCK. VICE CHAIRMAN 5 Dear Madam: e 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 D Headquarters and ask for your cooperation. Please answer the following questions and return this form to me, in enclosed envelope, at the earliest possible date, IMPORTANT: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross ELLA E. McNEIL, R.i.. Chairman or nurses should report at once to the STREET Secretary. Secretary of the Local Committee under PHILADELPHIA, PENNA. which they are enrolled. Do not forget Local Committee. the address of the Secretary. Name in full Josefains Clay If married, give husband's name Permanent address 90 Curtis (STREET, ETC.) Li Clay 1600achast (CITY) have Bhile (COUNTY) Pa. (STATE) Probable address for the next year (STREET, ETC.) Tel ephone No. (CITY) (COUNTY) (STATE) Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Underline Anthi the di Clay typé of 1600 work arch st Plula Brother you are now doingl - Army - Navy - U.S.P.H Hospital - U.S.Vet. Hospital - Public Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar. Have you ever been? Two Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? us Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Badge No. 5408 Current date 3/18/30 NOTE. . - If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrolment will be annulled.

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    "ocrText": "Form 1045 Rev. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nJOHN BARTON PAYNE, CHAIRMAN\nHERBERT HOOVER, 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\nJOSEPH P. COTTON\nCALVIN COOLIDGE, VICE PRESIDENT\nMRS. HENRY P. DAVISON\nCHARLES EVANS HUGHES, JR,, COUNSELOR\nNATIONAL HEADQUARTERS\nE.B. DOUGLAS\nOGDEN L. MILLS, TREASURER\nMRS. FRANK v. HAMMAR\nWASHINGTON, D.C.\nCHARLES EVANS HUGHES, JR.\n0\nMABEL T. BOARDMAN. SECRETARY\nMAJ. GEN. M. w. IRELAND\nJOHN BARTON PAYNE, CHAIRMAN\n34/2 for\nSAMUEL KNIGHT\nOGDEN L. MILLS\nS\nNATIONAL EXECUTIVE OFFICERS\nGUSTAVUS D. POPE\nMRS. HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\n6\nJAMES L. FIESER, VICE CHAIRMAN\nJOHN D. RYAN\nERNEST P. BICKNELL, VICE CHAIRMAN\nGEORGE E, SCOTT\nELIOT WADSWORTH\nJAMES K. McCLINTOCK. VICE CHAIRMAN\n5\nDear Madam:\ne\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\nD\nHeadquarters and ask for your cooperation. Please answer the following questions and\nreturn this form to me, in enclosed envelope, at the earliest possible date,\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nELLA E. McNEIL, R.i..\nChairman or\nnurses should report at once to the\nSTREET\nSecretary.\nSecretary of the Local Committee under\nPHILADELPHIA, PENNA.\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName in full Josefains Clay\nIf married, give husband's name\nPermanent address 90 Curtis (STREET, ETC.) Li Clay 1600achast (CITY) have Bhile (COUNTY)\nPa.\n(STATE)\nProbable address for the next year\n(STREET, ETC.)\nTel ephone No.\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency.\n(State relationship)\nUnderline\nAnthi the di Clay typé of 1600 work arch st Plula\nBrother\nyou are now doingl - Army - Navy - U.S.P.H Hospital - U.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nHave you ever been? Two\nAre you\nan instructor of Red Cross classes in Home Hygiene and Care of the Sick? us\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 5408\nCurrent date\n3/18/30\nNOTE. . - If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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