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FORM 1045--REV. 2-24-27
NATIONAL OFFICERS
CENTRAL COMMITTEE
CALVIN COOLIDGE. PRESIDENT
JOHN BARTON PAYNE, CHAIRMAN
MRS. AUGUST BELMONT
ROBERT W. DE FOREST, VICE PRESIDENT
CORNELIUS N. BLISS
WILLIAM HOWARD TAFT. VICE PRESIDENT
THE AMERICAN RED CROSS
MABEL T. BOARDMAN
WILLIAM D. MITCHELL, COUNSELOR
MRS. HENRY P. DAVISON
CHARLES S. DEWEY, TREASURER
NATIONAL HEADQUARTERS
CHARLES s. DEWEY
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
JOHN BARTON PAYNE, CHAIRMAN
W. W. MORROW
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
JAN 1 - 1928
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:
In order to render prompt service
CATHERINE G. BRIGGS, R.N.
Yours sincerely
Chairman or
in time of disaster, enrolled Red Cross
SEC'Y OF BOSTON LOCAL COMMITTEE
nurses should report at once to the
Secretary.
RED CROSS NURSING SERVICE
Secretary of the Local Committee under
29 LAKEVILLE PLACE
Local Committee.
which they are enrolled. Do not forget
JAMAICA PLAIN, MASS.
the address of the Secretary.
Name
in full Chantel6
If married, give husband's name
Frankler Man
Permanent address
Probable address for the next year
fame
Telephone No. Transler 394W
Name and address of nearest relative or friend, in United States, through whom you may
be communicated with in an emergency. (State relationship)
Ka tharme withens Franklin Mass
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?
Have you ever been?
no
Indicate present physical condition
Good
ban
not
Would you respond to an emergency call in event of epidemic, disaster, war, etc.?
Badge No.
Current date Jacy IF 7 28
NOTE.--I 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\nCALVIN COOLIDGE. PRESIDENT\nJOHN BARTON PAYNE, CHAIRMAN\nMRS. AUGUST BELMONT\nROBERT W. DE FOREST, VICE PRESIDENT\nCORNELIUS N. BLISS\nWILLIAM HOWARD TAFT. VICE PRESIDENT\nTHE AMERICAN RED CROSS\nMABEL T. BOARDMAN\nWILLIAM D. MITCHELL, COUNSELOR\nMRS. HENRY P. DAVISON\nCHARLES S. DEWEY, TREASURER\nNATIONAL HEADQUARTERS\nCHARLES s. DEWEY\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\nJOHN BARTON PAYNE, CHAIRMAN\nW. W. MORROW\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\nJAN 1 - 1928\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:\nIn order to render prompt service\nCATHERINE G. BRIGGS, R.N.\nYours sincerely\nChairman or\nin time of disaster, enrolled Red Cross\nSEC'Y OF BOSTON LOCAL COMMITTEE\nnurses should report at once to the\nSecretary.\nRED CROSS NURSING SERVICE\nSecretary of the Local Committee under\n29 LAKEVILLE PLACE\nLocal Committee.\nwhich they are enrolled. Do not forget\nJAMAICA PLAIN, MASS.\nthe address of the Secretary.\nName\nin full Chantel6\nIf married, give husband's name\nFrankler Man\nPermanent address\nProbable address for the next year\nfame\nTelephone No. Transler 394W\nName and address of nearest relative or friend, in United States, through whom you may\nbe communicated with in an emergency. (State relationship)\nKa tharme withens Franklin Mass\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?\nHave you ever been?\nno\nIndicate present physical condition\nGood\nban\nnot\nWould you respond to an emergency call in event of epidemic, disaster, war, etc.?\nBadge No.\nCurrent date Jacy IF 7 28\nNOTE.--I the nurse does not complete and return this questionnaire, and can not be\nlocated within two years, her enrollment will be annulled."
}