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I F ear F I Form 1045 Rev. 1-7-30 NATIONAL OFFICERS CENTRAL COMMITTEE JOHN BARTON PAYNE, CHAIRMAN - 3 HERBERT HOOVER, PRESIDENT ROBERT W. DE FOREST. VICE PRESIDENT MRS. AUGUST BELMONT THE AMERICAN RED CROSS CORNELIUS N. BLISS rs. WILLIAM HOWARD TAFT, VICE PRESIDENT MABEL T. BOARDMAN PCALWIN COOLIDGE, VICE PRESIDENT JOSEPH P. COTTON CHARLES EVANS HUGHES, JR., COUNSELOR NATIONAL HEADQUARTERS MRS. HENRY P. DAVISON E. B. DOUGLAS OGDEN L, MILLS, TREASURER WASHINGTON, D.C. MRS. FRANK v. HAMMAR MABEL T. BOARDMAN, SECRETARY CHARLES EVANS HUGHES, JR. M I 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 ari e JAMES L. FIESER, VICE CHAIRMAN JOHN D. RYAN ERNEST P. BICKNELL. VICE CHAIRMAN GEORGE E, SCOTT JAMES K. MECLINTOCK.VICE CHAIRMAN ELIOT WADSWORTH - Dear Madam: 0 M a 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 S 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 I return this form to me, in enclosed envelope, at the earliest possible date. IMPORTANT: In order to render prompt service Yours sincerely, in time of disaster, enrolled Red Cross Chairman or Mrs. Mabel C. Collins, nurses should report at once to the Segretary 17 Ridge St. Secretary of the Local Committee under Greenwich, Conn. which they are enrolled. Do not forget Local Committee. the address of the Secretary. Name in full Helen muriel Godsoe offer If married, give husband's name Hearry B. offen Permanent address new (CITY) common (COUNTY) Come (STATE) Stanfonderous (STREET, ETED Probable address for the next year same (STREET. ETC.) Tel ephone No. 425 same are above (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) Husband Underline the /type of stormand work ave, new Canaerm com 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 not very good Would you respond to an emergency call in event of epidemic, disaster, war,etc.? no 2 Badge No. 22964 Current date march able 1931 2 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": "I\nF\near\nF\nI\nForm 1045 Rev. 1-7-30\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nJOHN BARTON PAYNE, CHAIRMAN\n-\n3\nHERBERT HOOVER, PRESIDENT\nROBERT W. DE FOREST. VICE PRESIDENT\nMRS. AUGUST BELMONT\nTHE AMERICAN RED CROSS\nCORNELIUS N. BLISS\nrs.\nWILLIAM HOWARD TAFT, VICE PRESIDENT\nMABEL T. BOARDMAN\nPCALWIN COOLIDGE, VICE PRESIDENT\nJOSEPH P. COTTON\nCHARLES EVANS HUGHES, JR., COUNSELOR\nNATIONAL HEADQUARTERS\nMRS. HENRY P. DAVISON\nE. B. DOUGLAS\nOGDEN L, MILLS, TREASURER\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nMABEL T. BOARDMAN, SECRETARY\nCHARLES EVANS HUGHES, JR.\nM\nI\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\nari\ne\nJAMES L. FIESER, VICE CHAIRMAN\nJOHN D. RYAN\nERNEST P. BICKNELL. VICE CHAIRMAN\nGEORGE E, SCOTT\nJAMES K. MECLINTOCK.VICE CHAIRMAN\nELIOT WADSWORTH\n-\nDear Madam:\n0\nM\na\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\nS\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\nI\nreturn this form to me, in enclosed envelope, at the earliest possible date.\nIMPORTANT:\nIn order to render prompt service\nYours sincerely,\nin time of disaster, enrolled Red Cross\nChairman or\nMrs. Mabel C. Collins,\nnurses should report at once to the\nSegretary\n17 Ridge St.\nSecretary of the Local Committee under\nGreenwich, Conn.\nwhich they are enrolled. Do not forget\nLocal Committee.\nthe address of the Secretary.\nName\nin full Helen muriel Godsoe offer\nIf\nmarried, give husband's name Hearry B. offen\nPermanent address new (CITY) common (COUNTY) Come (STATE)\nStanfonderous\n(STREET, ETED\nProbable address for the next year\nsame\n(STREET. ETC.)\nTel ephone No. 425\nsame are above\n(CITY)\n(COUNTY)\n(STATE)\nName and address of nearest relative or friend, in United States, through whom you may\nbe\ncommunicated with in an emergency. (State relationship) Husband\nUnderline the /type of\nstormand\nwork ave, new Canaerm com\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\nHave you ever been?\nno\nIndicate present physical condition\nnot very good\nWould you respond to an emergency call in event of epidemic, disaster, war,etc.? no\n2\nBadge No. 22964\nCurrent date march able 1931\n2\nNOTE. - If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrolment will be annulled."
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