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G.B.
113 6
FORM No. 469-(2
THE AMERICAN RED CROSS
ENROLLMENT FORM
D
M
W
Voyage number
From Nursing Department Atlantie Dim
To
THE DIVISION OF TRANSPORTATION,
BUREAU OF PERSONNEL.
mo
Date 5=22=18
Approval of Director,
Ich
JST
Approved Clara Ducy's
Bureau of Personnel
1.
Name Hibbard, Alicia Elizabeth
2. Address
137-West 13th-s New York-City
3. Temporary address, if any
4. Going to what countries
France
5. Nature of work Infant Welfare
6. Suggested rank
7. Length of stay (six months or over?) 1-year-or-more
8. Proposed approximate date of departure
June 15Peoked
June 19
Sailed
8/8
9. Cable number in compliance with which above is being sent
2611 to
10. Is appointee volunteer?
No
11. If not volunteer, what salary per month is promised? $60.00
12. To begin June 12th
13. What allowance, if any, for transportation in United States? $ None
needed
14. What allowance, if any, for transportation (steamship)? Yes, both ways
15. What allowance, if any, for living expenses prior to departure? $ None needed
16. What allowance, if any, for uniform equipment? $ Requisitioned at New York Office
17. What allowance, if any, for living expenses abroad? $ Yes; regulation allowance
18. Is there to be an assignment of part or all of salary? #30. fer month
19. Has the proper form been sent to the Life Extension Institute?
Division of Transportation,
PLEASE LEAVE THE FOLLOWING LINES BLANK.
6/8
6/8
Correspondence checked:
Note
Forms
1-5-pel. /
7-72-8
Mailed
Clerk of the
Court at
Application for passport filed
Date
Issued
Reservation
Cancelled
Cabled
Cancelled
act 12-1871-
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Document data
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"ocrText": "G.B.\n113 6\nFORM No. 469-(2\nTHE AMERICAN RED CROSS\nENROLLMENT FORM\nD\nM\nW\nVoyage number\nFrom Nursing Department Atlantie Dim\nTo\nTHE DIVISION OF TRANSPORTATION,\nBUREAU OF PERSONNEL.\nmo\nDate 5=22=18\nApproval of Director,\nIch\nJST\nApproved Clara Ducy's\nBureau of Personnel\n1.\nName Hibbard, Alicia Elizabeth\n2. Address\n137-West 13th-s New York-City\n3. Temporary address, if any\n4. Going to what countries\nFrance\n5. Nature of work Infant Welfare\n6. Suggested rank\n7. Length of stay (six months or over?) 1-year-or-more\n8. Proposed approximate date of departure\nJune 15Peoked\nJune 19\nSailed\n8/8\n9. Cable number in compliance with which above is being sent\n2611 to\n10. Is appointee volunteer?\nNo\n11. If not volunteer, what salary per month is promised? $60.00\n12. To begin June 12th\n13. What allowance, if any, for transportation in United States? $ None\nneeded\n14. What allowance, if any, for transportation (steamship)? Yes, both ways\n15. What allowance, if any, for living expenses prior to departure? $ None needed\n16. What allowance, if any, for uniform equipment? $ Requisitioned at New York Office\n17. What allowance, if any, for living expenses abroad? $ Yes; regulation allowance\n18. Is there to be an assignment of part or all of salary? #30. fer month\n19. Has the proper form been sent to the Life Extension Institute?\nDivision of Transportation,\nPLEASE LEAVE THE FOLLOWING LINES BLANK.\n6/8\n6/8\nCorrespondence checked:\nNote\nForms\n1-5-pel. /\n7-72-8\nMailed\nClerk of the\nCourt at\nApplication for passport filed\nDate\nIssued\nReservation\nCancelled\nCabled\nCancelled\nact 12-1871-"
}