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Heilman, Mrs. Charlotte M. (1 of 2)

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I e Heilman, Mrs. Charlotte M. Badge #14,217 RED CROSS BADGE NUMBER a A AMERICAN RED CROSS 14217 NURSING SERVICES MILITARY SERIAL NUMBER ANNUAL QUESTIONNAIRE - 1945 CHECK IF YOUR LAST NAME HAS CHANGED No 3 NAME (Last, first, middle) NO. T Heilman Charlotte M. IF MARRIED, GIVE MAIDEN NAME HUSBAND'S NAME Miller Charlotte (Deceased) Charles J. PERMANENT ADDRESS (Street, city, zone, county, state) RD. PRESENT ADDRESS (Street, city, zone, county S tate) 1- Box 123 King George Rd. Bound Brook NJ. Ln same NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES RELATIONSHIP wn B. Miller - Lake Chaweva. P.D3. Charkston Brother DATE OF BIRTH (Month, day, year) Single Married Separated Widowed Nov. 25- 1880 D1 vorced WHAT LANGUAGES DO YOU SPEAK? YES NO Out of Practice Now Con get along in Holion Spanish Armah HIGH SCHOOL GRADUATE NAME OF COLLEGE OR DEGREE OR UNIVERSITY ATTENDED LOCATION 9 INCLUSIVE DATES DIPLOMA MAJOR Private Schools, and instructors .1.1.18 53712 of E to ARE YOU CURRENTLY YES NO REGISTERED IN (State) ARE/YOU CURRENTLY A MEMBER OF THE AMERICAN YES NO REGISTERED? N.V. NY2Nd. NURSES' ASSOCIATION? CONT PRESENT EMPLOYMENT If not employed, check POSITION TITLE (H.N., P.D., inst., staff nurse, etc.) / 12 SERVICE surgery, retc.) Nursing Field Rep. Amer Red Cross. No allontic area NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED CITY STATE American Nat Red Cross - Rotiving this year. HEALTH IF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY Rarely ill VOLUNTEER SERVICE The purpose of the following statements is to identify the nurses who can be counted upon to respond to a call to participate in a Red Cross chapter program. Please check the "Yes" box only if you are wi ling and able to serve if called on wi thin the next 12 months. NAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS On border between Bound Brook or Plainfield Chapters 1. Teach home YES NO Attend an instructors' training program, if offered. (Funds are available for YES NO nursing classes training home nursing instructors. See local chapter.) 2. Serve in case YES NO only in home community Attend disaster institutes, if YES NO of d!saster In other communities offered, in preparation for service 3. Teach nurse's YES NO 4. Accept membership on chapter cóm- YES NO 5. Assist with other chapter YES NO aide classes mittee should services be needed programs, as needed If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES NO you will be able to serve at some time in the future? IF UNABLE TO SERVE, GIVE MAJOR REASONS - DATE IGNATURE aug. 1945- Rarbia M. Huilmon YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHPOLNESS IN KEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY TO THE COMMITTEE NAMED BELOW. ATTENTION Fill in committee name and address before sending questionnaire to nurse. SECRETARY NURSE RECRUITMENT NATIONAL HEAORUARTERS COMMITTEE 78504M FORM 1045 Rev. July 1945 2 I

Page data

Page
39
Source index
0
Type
photo
Media ID
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Size
unknown

Document data

ID
2661623
Core
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Type
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    "coverageEndDate": {
        "day": 16,
        "logicalDate": "1955-03-16",
        "month": 3,
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    "ocrText": "I\ne\nHeilman, Mrs. Charlotte M.\nBadge #14,217\nRED CROSS BADGE NUMBER\na\nA\nAMERICAN RED CROSS\n14217\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nNo\n3\nNAME (Last, first, middle)\nNO.\nT\nHeilman Charlotte M.\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nMiller Charlotte\n(Deceased) Charles J.\nPERMANENT ADDRESS (Street, city, zone, county, state)\nRD.\nPRESENT ADDRESS (Street, city, zone, county S tate)\n1- Box 123 King George Rd. Bound Brook NJ.\nLn\nsame\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nwn B. Miller - Lake Chaweva. P.D3. Charkston\nBrother\nDATE OF BIRTH (Month, day, year)\nSingle\nMarried\nSeparated\nWidowed\nNov. 25- 1880\nD1 vorced\nWHAT LANGUAGES DO YOU SPEAK?\nYES\nNO\nOut of Practice Now Con get along in Holion Spanish Armah\nHIGH SCHOOL GRADUATE\nNAME OF COLLEGE OR\nDEGREE OR\nUNIVERSITY ATTENDED\nLOCATION\n9\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nPrivate Schools, and instructors\n.1.1.18\n53712\nof\nE\nto\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nARE/YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nN.V. NY2Nd.\nNURSES' ASSOCIATION?\nCONT\nPRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.) / 12\nSERVICE surgery, retc.)\nNursing Field Rep. Amer Red Cross. No allontic area\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nCITY\nSTATE\nAmerican Nat Red Cross - Rotiving this year.\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\nRarely ill\nVOLUNTEER SERVICE\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to a call\nto participate in a Red Cross chapter program. Please check the \"Yes\" box only if you are wi ling and able to\nserve if called on wi thin the next 12 months.\nNAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\nOn border between Bound Brook or Plainfield Chapters\n1. Teach home\nYES\nNO\nAttend an instructors' training program, if offered. (Funds are available for\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\n2. Serve in case\nYES\nNO\nonly in home community\nAttend disaster institutes, if\nYES\nNO\nof d!saster\nIn other communities\noffered, in preparation for service\n3. Teach nurse's\nYES\nNO\n4. Accept membership on chapter cóm-\nYES\nNO\n5. Assist with other chapter\nYES\nNO\naide classes\nmittee should services be needed\nprograms, as needed\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that\nYES\nNO\nyou will be able to serve at some time in the future?\nIF UNABLE TO SERVE, GIVE MAJOR REASONS -\nDATE\nIGNATURE\naug. 1945-\nRarbia M. Huilmon\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO SERVE AND YOUR FAITHPOLNESS IN\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONWAIRE AND RETURN IT PROMPTLY TO THE\nCOMMITTEE NAMED BELOW.\nATTENTION\nFill in committee name and address before sending questionnaire to nurse.\nSECRETARY\nNURSE RECRUITMENT\nNATIONAL HEAORUARTERS\nCOMMITTEE\n78504M\nFORM 1045 Rev. July 1945\n2\nI"
}