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FORM 1045--Rev. 2-24-27 NATIONAL OFFICERS CENTRAL COMMITTEE JOHN BARTON PAYNE, CHAIRMAN CALVIN COOLIDGE. PRESIDENT MRS. AUGUST BELMONT ROBERT W. DE FOREST. VICE PRESIDENT CORNELIUS N. BLISS WILLIAM HOWARD TAFT. VICE PRESIDENT THE AMERICAN RED CROSS MABEL T. BOARDMAN MRS. HENRY P. DAVISON WILLIAM D. MITCHELL, COUNSELOR NATIONAL HEADQUARTERS CHARLES S. DEWEY CHARLES S. DEWEY, TREASURER E. B. DOUGLAS MABEL T. BOARDMAN. SECRETARY WASHINGTON. D. C. JOSEPH c. GREW MRS. FRANK v. HAMMAR HERBERT HOOVER NATIONAL EXECUTIVE OFFICERS MAJ. GEN. M. W. IRELAND WILLIAM D. MITCHELL W. W. MORROW JOHN BARTON PAYNE. CHAIRMAN GUSTAVUS D. POPE JAMES L. FIESER, VICE CHAIRMAN MRS. HENRY R. REA ERNEST P. BICKNELL. VICE CHAIRMAN JOHN D. RYAN GEORGE E. SCOTT REAR ADMIRAL E, R, STITT 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 the enclosed envelope, at the earliest possible date. IMPORTANT: Yours sincerely, In order to render prompt service nurses should report at once to the Reopla gillence Chairman Secretary. or in time of disaster, enrolled Red Cross Secretary of the Local Committee under San Francisco Local Committee. which they are enrolled. Do not forget the address of the Secretary. Name in full mary From Kyle If married, give husband's name Permanent address 2140 Scott st Sau Francisco Probable address for the next year Same Calef Telephone No. Selmore 4778 Name and address of nearest relative or friend, in United States, through whom you may be communicated with in an emergency. (State relationship) Mrs Florence Down 2140 Scott st S.F. 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 Have you ever been? no Indicate present physical condition good Would you respond to an emergency call in event of epidemic, disaster, war, etc.? Badge No. 8961 Current date april 20 1928 NOTE. If the nurse does not complete and return this questionnaire, and can not be located within two years, her enrollment will be annulled.

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    "ocrText": "FORM 1045--Rev. 2-24-27\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nJOHN BARTON PAYNE, CHAIRMAN\nCALVIN COOLIDGE. PRESIDENT\nMRS. AUGUST BELMONT\nROBERT W. DE FOREST. VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nMRS. HENRY P. DAVISON\nWILLIAM D. MITCHELL, COUNSELOR\nNATIONAL HEADQUARTERS\nCHARLES S. DEWEY\nCHARLES S. DEWEY, TREASURER\nE. B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nWASHINGTON. D. C.\nJOSEPH c. GREW\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. M. W. IRELAND\nWILLIAM D. MITCHELL\nW. W. MORROW\nJOHN BARTON PAYNE. CHAIRMAN\nGUSTAVUS D. POPE\nJAMES L. FIESER, VICE CHAIRMAN\nMRS. HENRY R. REA\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nGEORGE E. SCOTT\nREAR ADMIRAL E, R, STITT\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 the enclosed envelope, at the earliest possible date.\nIMPORTANT:\nYours sincerely,\nIn order to render prompt service\nnurses should report at once to the\nReopla gillence Chairman Secretary.\nor\nin time of disaster, enrolled Red Cross\nSecretary of the Local Committee under\nSan Francisco\nLocal Committee.\nwhich they are enrolled. Do not forget\nthe address of the Secretary.\nName in full\nmary From Kyle\nIf married, give husband's name\nPermanent address\n2140 Scott st Sau Francisco\nProbable address for the next year\nSame\nCalef\nTelephone No. Selmore 4778\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nMrs Florence Down 2140 Scott st S.F.\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?\nno\nHave you ever been? no\nIndicate present physical condition good\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No. 8961\nCurrent date april 20\n1928\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}