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Tate, Audrey Marie

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RED CROSS BADGE NUMBER AMERICAN RED CROSS 58962 NURSING SERVICES MILITARY SERIAL NUMBER ANNUAL QUESTIONNAIRE - 1945 CHECK IF YOUR LAST NAME HAS CHANGED NAME (Last, first, middle) TELEPHONE NO. TATE , AudREY MHRIE Someoville 516 IF MARRIED, GIVE MAIDEN NAME HUSBAND'S NAME PERMANENT ADDRESS (Street, city, zone, county, state) PRESENT 1655-34th ADDRESS (Street, city, zone, St. county, n. W. state) Washington , D. C 185 n. Bridge st. Somervilli, IV.J. NAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES RELATIONSHIP DATE OF BIRTH (Month, day, year) Anna MAVIE /A their mother September YOU 30, 1912 Single Married Separated Widowed Divorced WHAT LANGUAGES DO SPEAK? YES NO HIGH SCHOOL GRADUATE none NAME OF COLLEGE OR DEGREE OR UNIVERSITY ATTENDED LOCATION INCLUSIVE DATES DIPLOMA MAJOR ARE YOU CURRENTLY YES NO REGISTERED IN (State) ARE YOU CURRENTLY A MEMBER OF THE AMERICAN YES NO REGISTERED? Washington D.C. NURSES' ASSOCIATION? PRESENT EMPLOYMENT If not employed, check POSITION TITLE (H.N., P.D., inst., staff nurse, etc.) SERVICE (Medicine, surgery, etc.) Industrial NAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED CITY STATE Shemin Williams Bound Brooking HEALTH IF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY good VOLUNTEER SERVICE The purpose of the following statements is to identify the nurses who can be counted upon to respond to a call to participate in a Red Cross chapter program. Please check the "Yes" box only if you are willing and able to serve if called on within the next 12 months. NAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS new Brunswech n.J. 108 Church st 1. Teach home YES NO Attend an instructors' training program, if offered. (Funds are available for YES NO nursing classes training home nursing instructors. See local chapter.) 2. Serve in case YES NO only in home community Attend disaster institutes, if YES NO of disaster In other communities offered, in preparation for service 3. Teach nurse's YES NO 4. Accept membership on chapter com- YES NO, 5. Assist with other chapter YES NO aide classes mittee should services be needed programs, as needed If you have not answered "Yes" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES NO you will be able to serve at some time in the future? IF UNABLE TO SERVE, GIVE MAJOR REASONS. 6/14/15 DATE SIGNATURE 18-17-45 YOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO auding SERVE AND YOUR maine FAITHFULNESS Tate IN KEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE COMMITTEE NAMED BELOW. ATTENTION Fill in committee name and address before sending questionnaire to nurse. SECRETARY AMERICAN RED CROSS NURSE RECRUITMENT 108 CHURCH ST. COMMITTEE NEW BRUNSWICK, N. J. 78504M FORM 1045 Rev. July 1945

Page data

Page
7
Source index
0
Type
photo
Media ID
b35e2e2fb74472a2
Size
unknown

Document data

ID
2662340
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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Document source extras 
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    "naId": 2662340,
    "coverageEndDate": {
        "day": 12,
        "logicalDate": "1945-09-12",
        "month": 9,
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        "logicalDate": "1934-04-06",
        "month": 4,
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    },
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    "ocrText": "RED CROSS BADGE NUMBER\nAMERICAN RED CROSS\n58962\nNURSING SERVICES\nMILITARY SERIAL NUMBER\nANNUAL QUESTIONNAIRE - 1945\nCHECK IF YOUR LAST NAME HAS CHANGED\nNAME (Last, first, middle)\nTELEPHONE NO.\nTATE , AudREY MHRIE\nSomeoville 516\nIF MARRIED, GIVE MAIDEN NAME\nHUSBAND'S NAME\nPERMANENT ADDRESS (Street, city, zone, county, state)\nPRESENT\n1655-34th ADDRESS (Street, city, zone, St. county, n. W. state) Washington , D. C\n185 n. Bridge st. Somervilli, IV.J.\nNAME AND ADDRESS OF NEAREST RELATIVE OR FRIEND IN THE UNITED STATES\nRELATIONSHIP\nDATE OF BIRTH (Month, day, year)\nAnna MAVIE /A their\nmother\nSeptember YOU 30, 1912\nSingle\nMarried\nSeparated\nWidowed\nDivorced\nWHAT LANGUAGES DO SPEAK?\nYES\nNO\nHIGH SCHOOL GRADUATE\nnone\nNAME OF COLLEGE OR\nDEGREE OR\nUNIVERSITY ATTENDED\nLOCATION\nINCLUSIVE DATES\nDIPLOMA\nMAJOR\nARE YOU CURRENTLY\nYES\nNO\nREGISTERED IN (State)\nARE YOU CURRENTLY A MEMBER OF THE AMERICAN\nYES\nNO\nREGISTERED?\nWashington D.C.\nNURSES' ASSOCIATION?\nPRESENT EMPLOYMENT If not employed, check\nPOSITION TITLE (H.N., P.D., inst., staff nurse, etc.)\nSERVICE (Medicine, surgery, etc.)\nIndustrial\nNAME OF HOSPITAL OR ORGANIZATION BY WHOM EMPLOYED\nCITY\nSTATE\nShemin Williams Bound Brooking\nHEALTH\nIF OTHER THAN GOOD, SPECIFY NATURE AND ANTICIPATED DURATION OF DISABILITY\ngood\nVOLUNTEER SERVICE\nThe purpose of the following statements is to identify the nurses who can be counted upon to respond to a call\nto participate in a Red Cross chapter program. Please check the \"Yes\" box only if you are willing and able to\nserve if called on within the next 12 months.\nNAME AND ADDRESS OF THE CHAPTER IN WHOSE JURISDICTION YOU EXPECT TO LIVE FOR THE NEXT 12 MONTHS\nnew Brunswech n.J. 108 Church st\n1. Teach home\nYES\nNO Attend an instructors' training program, if offered. (Funds are available for\nYES\nNO\nnursing classes\ntraining home nursing instructors. See local chapter.)\n2. Serve in case\nYES\nNO\nonly in home community\nAttend disaster institutes, if\nYES\nNO\nof disaster\nIn other communities\noffered, in preparation for service\n3. Teach nurse's\nYES\nNO\n4. Accept membership on chapter com-\nYES\nNO,\n5. Assist with other chapter\nYES\nNO\naide classes\nmittee should services be needed\nprograms, as needed\nIf you have not answered \"Yes\" to any of the questions listed under VOLUNTEER SERVICE, do you anticipate that YES\nNO\nyou will be able to serve at some time in the future?\nIF UNABLE TO SERVE, GIVE MAJOR REASONS.\n6/14/15\nDATE\nSIGNATURE\n18-17-45\nYOUR VALUE AS A RED CROSS NURSE DEPENDS ON YOUR ABILITY AND WILLINGNESS TO\nauding SERVE AND YOUR maine FAITHFULNESS Tate IN\nKEEPING US INFORMED OF YOUR ADDRESS. PLEASE FILL IN THIS QUESTIONNAIRE AND RETURN IT PROMPTLY TO THE\nCOMMITTEE NAMED BELOW.\nATTENTION\nFill in committee name and address before sending questionnaire to nurse.\nSECRETARY\nAMERICAN RED CROSS\nNURSE RECRUITMENT\n108 CHURCH ST.\nCOMMITTEE\nNEW BRUNSWICK, N. J.\n78504M\nFORM 1045 Rev. July 1945"
}