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I + Special FORM 1045 REV. 2-16-31 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER, PRESIDENT JOHN BARTON PAYNE, CHAIRMAN ROBERT w. DE FOREST. VICE PRESIDENT MRS. AUGUST BELMONT THE AMERICAN RED CROSS CORNELIUS N. BLISS CALVIN COOLIDGE, VICE PRESIDENT MABEL T. BOARDMAN CHARLES EVANS HUGHES, VICE PRESIDENT JOSEPH P. COTTON THOMAS D. THACHER, COUNSELOR NATIONAL HEADQUARTERS MRS HENRY P. DAVISON MRS. FRANK v. HAMMAR OGDEN L. MILLS, TREASURER WASHINGTON, D.C. MAJ. GEN M. w. IRELAND MABEL T. BOARDMAN. SECRETARY SAMUEL KNIGHT OGDEN L. MILLS GUSTAVUS D. POPE NATIONAL EXECUTIVE OFFICERS MRS, HENRY R REA REAR ADMIRAL CHARLES E. RIGGS JOHN BARTON PAYNE, CHAIRMAN JOHN D. RYAN JAMES L. FIESER, VICE CHAIRMAN GEORGE E. SCOTT ERNEST P. BICKNELL, VICE CHAIRMAN HENRY UPSON SIMS THOMAS D. THACHER JAMES K. MCCLINTOCK, VICE CHAIRMAN ELIOT WADSWORTH miss game Hilehird Whitney. Hailford Come march 23/31 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 enclosed envelope, at the earliest possible date. IMPORTANT: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross Nurses should report at once to the Harried E Chairman Secretary. or Secretary of the Local Committee under which they are enrolled. Do not forget Strutfuel Local Committee. the address of the Secretary. Name in full Jane Elizabeth Hitchcock. If married, give husband's name Un married Permanent address 185, So Whitney. St, - Hartford- CITY Hartford Conn Contemptate change. willnoti ETC. ty. COUNTY STATE Probable address for the next year STREET, ETC. Telephone No. 4-8437 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) Brother Albert White Hitchcock 183 Bawthorn ST. - -Hartford, Conn. Underline the type of work you are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian Service - Public Health - Institutional - Private Duty - Industrial - Office Nurse - Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no Registrar. Retired Public Heath nurse a Instructor Have you ever been? yes. During world wat- Indicate present physical condition Excellent Would you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes Travelling. Badge no. not-valiable. SpecidBadge No. Current date April - 8 - 1981 NOTE.- 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": "I\n+\nSpecial\nFORM 1045 REV. 2-16-31\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nCALVIN COOLIDGE, VICE PRESIDENT\nMABEL T. BOARDMAN\nCHARLES EVANS HUGHES, VICE PRESIDENT\nJOSEPH P. COTTON\nTHOMAS D. THACHER, COUNSELOR\nNATIONAL HEADQUARTERS\nMRS HENRY P. DAVISON\nMRS. FRANK v. HAMMAR\nOGDEN L. MILLS, TREASURER\nWASHINGTON, D.C.\nMAJ. GEN M. w. IRELAND\nMABEL T. BOARDMAN. SECRETARY\nSAMUEL KNIGHT\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nNATIONAL EXECUTIVE OFFICERS\nMRS, HENRY R REA\nREAR ADMIRAL CHARLES E. RIGGS\nJOHN BARTON PAYNE, CHAIRMAN\nJOHN D. RYAN\nJAMES L. FIESER, VICE CHAIRMAN\nGEORGE E. SCOTT\nERNEST P. BICKNELL, VICE CHAIRMAN\nHENRY UPSON SIMS\nTHOMAS D. THACHER\nJAMES K. MCCLINTOCK, VICE CHAIRMAN\nELIOT WADSWORTH\nmiss game Hilehird Whitney. Hailford\nCome\nmarch 23/31\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 enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nNurses should report at once to the\nHarried E Chairman Secretary.\nor\nSecretary of the Local Committee under\nwhich they are enrolled. Do not forget\nStrutfuel\nLocal Committee.\nthe address of the Secretary.\nName in\nfull Jane Elizabeth Hitchcock.\nIf married, give husband's name\nUn married\nPermanent address 185, So Whitney. St, - Hartford- CITY Hartford\nConn\nContemptate change. willnoti ETC. ty.\nCOUNTY\nSTATE\nProbable address for the next year\nSTREET, ETC.\nTelephone No. 4-8437\nCITY\nCOUNTY\nSTATE\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship) Brother\nAlbert White Hitchcock 183 Bawthorn ST. - -Hartford, Conn.\nUnderline the type of work\nyou are now doing: Army - Navy - U.S.P.H. Hospital - U.S. Vet. Hospital - U.S. Indian\nService - Public Health - Institutional - Private Duty - Industrial - Office Nurse\n-\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? no\nRegistrar.\nRetired Public Heath nurse a Instructor\nHave you ever been? yes. During world wat-\nIndicate present physical condition\nExcellent\nWould you respond to an emergency call in event of epidemic, disaster, war, etc. ? yes\nTravelling. Badge no. not-valiable.\nSpecidBadge No.\nCurrent date April - 8 - 1981\nNOTE.- 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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