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5
FORM 1045
REV. OCT. 1943
AMERICAN RED CROSS
oh
ClaeY
Segso
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
anY 101
Red Cross
If you have changed your last name
Badge number 33898
since contacting us, please check here.
Name in full
Hobein
Cora
Flossie
(last)
(first)
(middle)
Tel. No. 2044 Barrington
F
If married, give maiden name
Date of birth
0
Marital status
Husband's name
to and bas
S
(single, married, widowed, divorced)
Cook
S
Permanent address
400 (street) grore are Barrington (city)
Illinois
-
(county)
(state)
Present
address 400 are. Barrington (city)
Cook
Ill
e
(county)
(state)
Notify national headquarters immediately if you change your address.
woH
Give name and address of nearest relative or friend in the United States:
Benf (name) H. Hobein, 400 grore (address) are Barrington , all. (relationship) Brother
Are you employed in nursing at the present time? Yes
No
If employed, check the type of work you are doing and fill in below the title of your position and the name
and address of the agency or institution:
Institutional
Public Health
Industrial
Private Duty
Other
If not employed, what type of nursing would you prefer to render? Teaching Home-hursing Class
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you :
Immediately available?
Available in the near future?
(specify date)
Not available, for the following reason ?
(specify)
Do you have any dependents under 14 years of age? Yes
No
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
A
BA
suoy
BIEISO
To teach Red Cross Home Nursing classes?
To teach volunteer nurse's aides?
To take a Red Cross emergency assignment?
and
to
ni
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If yes, specify type of disaster
(gito)
(deanda)
Page data
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- Source index
- 0
- Type
- photo
- Media ID
- 815c8f75ddfb6164
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Document data
- ID
- 2661648
- Core
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- Type
- document
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"ocrText": "I\n5\nFORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\noh\nClaeY\nSegso\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nanY 101\nRed Cross\nIf you have changed your last name\nBadge number 33898\nsince contacting us, please check here.\nName in full\nHobein\nCora\nFlossie\n(last)\n(first)\n(middle)\nTel. No. 2044 Barrington\nF\nIf married, give maiden name\nDate of birth\n0\nMarital status\nHusband's name\nto and bas\nS\n(single, married, widowed, divorced)\nCook\nS\nPermanent address\n400 (street) grore are Barrington (city)\nIllinois\n-\n(county)\n(state)\nPresent\naddress 400 are. Barrington (city)\nCook\nIll\ne\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nwoH\nGive name and address of nearest relative or friend in the United States:\nBenf (name) H. Hobein, 400 grore (address) are Barrington , all. (relationship) Brother\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nIf not employed, what type of nursing would you prefer to render? Teaching Home-hursing Class\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you :\nImmediately available?\nAvailable in the near future?\n(specify date)\nNot available, for the following reason ?\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nA\nBA\nsuoy\nBIEISO\nTo teach Red Cross Home Nursing classes?\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nand\nto\nni\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf yes, specify type of disaster\n(gito)\n(deanda)"
}