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OCR Page 1 of 180F
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IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND:
CHECK THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
3
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must
Physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be-
Physically fit, single OR married, and under 40. If qualified for supervision, anaesthesia,
operating room work, or interested in overseas assignment, the age limit is the 45th
birthday. very wehl qualified for any of these Services BUT hittle
over 45-. also free, Good Health WITH be ResponsiBilitis.
If eligible and not already in service, are you
Immediately available
Available in the near future
(specify date)
I
1
Not available for the following reasons
(specify)
If married, do you have minor dependents?
(specify)
If the Army decides to accept nurses from 40 to 44 years of age (inclusive) for all assignments, would you be
Immediately available
Available in the near future
(specify date)
Not available for the following reasons
over 45.
(specify)
AVAILABILITY FOR SERVICE WITH CIVILIANS
If not already doing so, will you
Teach Red Cross Home Nursing classes, if qualified? already Teaching When presides.
Teach Volunteer Nurse's Aides, if qualified? yes,
(3wound very giad To SERVE wirt Such
Serve with an overseas unit caring for civilian casualties?) a uniT. , was with G.R.C. in hast WOR Wour
Be available for emergency Red Cross assignments?
Like yes very much To Be electricites again.
PHYSICAL CONDITION
Have you been rejected for military service?
Yes
No
Why?
Do you believe that you could now meet revised physical requirements for military service?
Yes
No
State present physical condition Very good
If any disabilities, please specify
Red Cross Badge No. 10229
Dec.17,1942
(date this form is filled in)
MRS. MARGARET D. ULLRICH, R.N.
Name of committee
SECRETARY;
(to be filled in by committee before questionnaire is sent to RED CROSS LURSING SF. M.CE
7 HANOVER PLACE
BROOKLYN, N. Y.
YOUR VALUE AS A RED CROSS RESERVE NURSE DEPENDS ON OUR ABILITY TO LOCATE YOU. THE NATIONAL
EMERGENCY EMPHASIZES THIS FACT MORE THAN EVER. THANK YOU FOR FILLING IN THIS QUESTIONNAIRE
AND RETURNING IT TO US.
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