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FORM 1045-A REV. 7-9-32 NATIONAL OFFICERS CENTRAL COMMITTEE HERBERT HOOVER. PRESIDENT JOHN BARTON PAYNE. CHAIRMAN CALVIN COOLIDGE, VICE PRESIDENT CHARLES EVANS HUGHES. VICE PRESIDENT THE AMERICAN RED CROSS ARTHUR A. BALLANTINE MRS. AUGUST BELMONT THOMAS D. THACHER. COUNSELOR CORNELIUS N. BLISS NATIONAL HEADQUARTERS MABEL T. BOARDMAN ARTHUR A. BALLANTINE, TREASURER WILLIAM R. CASTLE, JR. MABEL T. BOARDMAN, SECRETARY WASHINGTON, D. C. MRS. HENRY P. DAVISON MRS. FRANK v. HAMMAR SAMUEL KNIGHT NATIONAL EXECUTIVE OFFICERS MAJ. GEN. ROBERT U. PATTERSON GUSTAVUS D. POPE JOHN BARTON PAYNE. CHAIRMAN MRS. HENRY R. REA JAMES L. FIESER, VICE CHAIRMAN REAR ADMIRAL CHARLES E. RIGGS ERNEST P. BICKNELL. VICE CHAIRMAN JOHN D. RYAN JAMES K. McCLINTOCK, VICE CHAIRMAN JAN 7 1933 GEORGE E. SCOTT HENRY UPSON SIMS THOMAS D. THACHER 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? Yours sincerely, IMPORTANT: In order to render prompt service Clasa Droges in time of disaster, enrolled Red Cross 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 Lucy Minnigarode If married, give husband's name Permanent address K.1-12 (STREET, ETC) Alexan, rea (CITY) (COUNTY) Pay ma (STATE) Probable address for the next year xr (STREET, ETC.) Telephone No. Nat 5714 (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) Power circuran nat Garliag wach. or Underline the type of work you are now doing: Army - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service - 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? ni Indicate present physical condition Fare, Would you respond to an emergency call in event of epidemic, disaster, war, etc.? ye Badge No 1418 Current date lau 9, 1933 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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36
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photo
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    "ocrText": "FORM 1045-A REV. 7-9-32\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nHERBERT HOOVER. PRESIDENT\nJOHN BARTON PAYNE. CHAIRMAN\nCALVIN COOLIDGE, VICE PRESIDENT\nCHARLES EVANS HUGHES. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nARTHUR A. BALLANTINE\nMRS. AUGUST BELMONT\nTHOMAS D. THACHER. COUNSELOR\nCORNELIUS N. BLISS\nNATIONAL HEADQUARTERS\nMABEL T. BOARDMAN\nARTHUR A. BALLANTINE, TREASURER\nWILLIAM R. CASTLE, JR.\nMABEL T. BOARDMAN, SECRETARY\nWASHINGTON, D. C.\nMRS. HENRY P. DAVISON\nMRS. FRANK v. HAMMAR\nSAMUEL KNIGHT\nNATIONAL EXECUTIVE OFFICERS\nMAJ. GEN. ROBERT U. PATTERSON\nGUSTAVUS D. POPE\nJOHN BARTON PAYNE. CHAIRMAN\nMRS. HENRY R. REA\nJAMES L. FIESER, VICE CHAIRMAN\nREAR ADMIRAL CHARLES E. RIGGS\nERNEST P. BICKNELL. VICE CHAIRMAN\nJOHN D. RYAN\nJAMES K. McCLINTOCK, VICE CHAIRMAN\nJAN 7 1933\nGEORGE E. SCOTT\nHENRY UPSON SIMS\nTHOMAS D. THACHER\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?\nYours sincerely,\nIMPORTANT:\nIn order to render prompt service\nClasa Droges\nin time of disaster, enrolled Red Cross\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 Lucy Minnigarode\nIf married, give husband's name\nPermanent address K.1-12 (STREET, ETC) Alexan, rea (CITY) (COUNTY) Pay ma (STATE)\nProbable address for the next year xr\n(STREET, ETC.)\nTelephone No. Nat 5714\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. (State relationship)\nPower circuran nat Garliag wach. or\nUnderline the type of work you are now doing:\nArmy - Navy - U.S.P.H. Service - U.S. Vet. Administration - U.S. Indian Service\n-\nPublic Health - 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?\nni\nIndicate present physical condition Fare,\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.? ye\nBadge No 1418\nCurrent\ndate lau 9, 1933\nNOTE. If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
}