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Form 1045
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE. PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
ROBERT w. DE FOREST, VICE PRESIDENT
MRS. AUGUST BELMONT
WILLIAM HOWARD TAFT. VICE PRESIDENT
CORNELIUS N. BLISS
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
WILLIAM D. MITCHELL, COUNSELOR
MRS, HENRY P. DAVISON
GARDARD B. WINSTON, TREASURER
NATIONAL HEADQUARTERS
E.B. DOUGLAS
MABEL T. BOARDMAN. SECRETARY
JOSEPH c. GREW
WASHINGTON, D.C.
MRS. FRANK v. HAMMAR
HERBERT HOOVER
MAJ. GEN. M, w. IRELAND
NATIONAL EXECUTIVE OFFICERS
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
GARRARD B. WINSTON
Dear Madam:
As you undoubtedly know, 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 know that you are very busy, but 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.
Yours sincerely,
MISS ANNA E. BAILEY, SECTY.,
Chairman or
188 Baker street
Secretary.
PROVIDENCE,
-
-
R.I.
Local Committee.
Name in
full Ada H Staffned
If married, give husband's name
Permanent address Industrial Irust Co Condune RU
Probable address for the next year Home poaten Aspect
Pindunce KD,
Telephone No.
Name
and
address
of
nearest rolative staffand
(State relationship)
10 Barnes sr
Underline the type of work
you are now doing:
- Army - Navy - U.S.P.H.Hospital - J.S.Vet.Hospital - Public
Health - Institutional - Private Duty - Industrial - Office Nurse - Registrar
Have you ever been?
Are you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? yes
Indicate present physical condition Gord
Would yes
you respond to an emergency call in event of epidemic, disaster, war, etc. ?
Badge No.
Current date Apr. 17' 1926
NOTE.- -If the nurse does not complete and return this questionnaire, and can not be
located within two years, her enrollment will be annulled.
Page data
- Page
- 21
- Source index
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- Type
- photo
- Media ID
- 74fab3c1db14b237
- Size
- unknown
Document data
- ID
- 2662299
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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"ocrText": "t\nForm 1045\nNATIONAL OFFICERS\nCENTRAL COMMITTEE\nCALVIN COOLIDGE. PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nROBERT w. DE FOREST, VICE PRESIDENT\nMRS. AUGUST BELMONT\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nCORNELIUS N. BLISS\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL, COUNSELOR\nMRS, HENRY P. DAVISON\nGARDARD B. WINSTON, TREASURER\nNATIONAL HEADQUARTERS\nE.B. DOUGLAS\nMABEL T. BOARDMAN. SECRETARY\nJOSEPH c. GREW\nWASHINGTON, D.C.\nMRS. FRANK v. HAMMAR\nHERBERT HOOVER\nMAJ. GEN. M, w. IRELAND\nNATIONAL EXECUTIVE OFFICERS\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\nGARRARD B. WINSTON\nDear Madam:\nAs you undoubtedly know, the National Committee on Red Cross Nursing Service\nrequires us to submit, annually, a list of all the Red Cross Nurses enrolled with our\nCommittee, with their latest addresses. We know that you are very busy, but we are\nextremely anxious to make a very complete report to National Headquarters and ask for\nyour cooperation. Please answer the following questions and return this form to me,\nin the enclosed envelope, at the earliest possible date.\nYours sincerely,\nMISS ANNA E. BAILEY, SECTY.,\nChairman or\n188 Baker street\nSecretary.\nPROVIDENCE,\n-\n-\nR.I.\nLocal Committee.\nName in\nfull Ada H Staffned\nIf married, give husband's name\nPermanent address Industrial Irust Co Condune RU\nProbable address for the next year Home poaten Aspect\nPindunce KD,\nTelephone No.\nName\nand\naddress\nof\nnearest rolative staffand\n(State relationship)\n10 Barnes sr\nUnderline the type of work\nyou are now doing:\n- Army - Navy - U.S.P.H.Hospital - J.S.Vet.Hospital - Public\nHealth - Institutional - Private Duty - Industrial - Office Nurse - Registrar\nHave you ever been?\nAre you an instructor of Red Cross classes in Home Hygiene and Care of the Sick? yes\nIndicate present physical condition Gord\nWould yes\nyou respond to an emergency call in event of epidemic, disaster, war, etc. ?\nBadge No.\nCurrent date Apr. 17' 1926\nNOTE.- -If the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}