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Form 1045- A Rev. 1-7-30
NATIONAL OFFICERS
CENTRAL COMMITTEE
HERBERT HOOVER, PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
MRS. AUGUST BELMONT
ROBERT w. DE FOREST. VICE PRESIDENT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
CALVIN COOLIDGE, VICE PRESIDENT
JOSEPH P. COTTON
NATIONAL HEADQUARTERS
MRS HENRY P. DAVISON
CHARLES EVANS HUGHES, JR., COUNSELOR
E.B. DOUGLAS
a
OGDEN L. MILLS, TREASURER
WASHINGTON, D.C.
MRS. FRANK v. HAMMAR
MABEL T. BOARDMAN. SECRETARY
CHARLES EVANS HUGHES, JR.
MAJ. GEN. M. w. IRELAND
SAMUEL KNIGHT
NATIONAL EXECUTIVE OFFICERS
OGDEN L. MILLS
GUSTAVUS D. POPE
JOHN BARTON PAYNE. CHAIRMAN
MRS, HENRY R. REA
REAR ADMIRAL CHARLES E. RIGGS
JAMES L. FIESER, VICE CHAIRMAN
JOHN D. RYAN
ERNEST P. BICKNELL. VICE CHAIRMAN
GEORGE E, SCOTT
JAMES K. MCCLINTOCK, VICE CHAIRMAN
ELIOT WADSWORTH
Dear Madam:
The National Committee on Red Cross Nursing Service requires us to submit,
annually, a list of all enrolled Red Cross Nurses with their latest addresses. We are
extremely anxious to make a very complete report and ask for your cooperation. Will
you kindly answer the following questions and return this form to me, in the enclosed
envelope, at the earliest possible date?
IMPORTANT:
Yours sincerely,
In order to render prompt service
in time of disaster, enrolled Red Cross
Clara D. rayes
nurses should report at once to the
National Director,
Secretary of the Local Committee under
Red Cross Nursing Service
which they are enrolled. Do not forget
the address of the Secretary.
Name in full Hartianie W. Holues
If married, give husband's name
Permanent address Pand It Fraulalin Norfolls Mass.
(STREET. ETC.)
(CITY)
(COUNTY)
(STATE)
Probable address for the next year
same
(STREET. ETC.)
Telephone No. 689-M
Fraulshin
(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)
Elizablete L. Holmes (sister) 115 shoundiffe Newtri, lass, Road
Underline the type of work
you are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar.
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No
Nonussing worls.
Have you ever been? No
Indicate present physical condition arthritis
Would you respond to an emergency call in event of epidemic, disaster, war,
etc. ? unable.
Badge No.
Current date June 27,1930
NOTE. If 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": "Form 1045- A Rev. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER, PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. AUGUST BELMONT\nROBERT w. DE FOREST. VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nJOSEPH P. COTTON\nNATIONAL HEADQUARTERS\nMRS HENRY P. DAVISON\nCHARLES EVANS HUGHES, JR., COUNSELOR\nE.B. DOUGLAS\na\nOGDEN L. MILLS, TREASURER\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN. SECRETARY\nCHARLES EVANS HUGHES, JR.\nMAJ. GEN. M. w. IRELAND\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nOGDEN L. MILLS\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE. CHAIRMAN\nMRS, HENRY R. REA\nREAR ADMIRAL CHARLES E. RIGGS\nJAMES L. FIESER, VICE CHAIRMAN\nJOHN D. RYAN\nERNEST P. BICKNELL. VICE CHAIRMAN\nGEORGE E, SCOTT\nJAMES K. MCCLINTOCK, VICE CHAIRMAN\nELIOT WADSWORTH\nDear Madam:\nThe National Committee on Red Cross Nursing Service requires us to submit,\nannually, a list of all enrolled Red Cross Nurses with their latest addresses. We are\nextremely anxious to make a very complete report and ask for your cooperation. Will\nyou kindly answer the following questions and return this form to me, in the enclosed\nenvelope, at the earliest possible date?\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nin time of disaster, enrolled Red Cross\nClara D. rayes\nnurses should report at once to the\nNational Director,\nSecretary of the Local Committee under\nRed Cross Nursing Service\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full Hartianie W. Holues\nIf married, give husband's name\nPermanent address Pand It Fraulalin Norfolls Mass.\n(STREET. ETC.)\n(CITY)\n(COUNTY)\n(STATE)\nProbable address for the next year\nsame\n(STREET. ETC.)\nTelephone No. 689-M\nFraulshin\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency.\n(State relationship)\nElizablete L. Holmes (sister) 115 shoundiffe Newtri, lass, Road\nUnderline the type of work\nyou are now doing: - Army - Navy - U.S.P.H. Hospital - U.S.Vet. Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar.\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? No\nNonussing worls.\nHave you ever been? No\nIndicate present physical condition arthritis\nWould you respond to an emergency call in event of epidemic, disaster, war,\netc. ? unable.\nBadge No.\nCurrent date June 27,1930\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}