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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."
}