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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."
}