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12. Professional affiliations: Of what State nurses' association are you a member Ky ? try dy State (Name) Board of new (Title and organization) Extern. 604-5-314 (Address) Lanicuary To whom and when did you last pay your dues Jan 1943- (Year) If not a member, when and where do you plan to join ? / In what State are you registered ? ty What year? 1934 Registration number 5104 If not registered, when and in what State will you take your State board examination ? (State) (Date) 13. Present position : Field of nursing Major responsibilities Institutional Private duty Administration General duty Public health Other (specify below) Supervision Private duty Industrial Teaching Other (specify below) T e 14. Give in chronological order positions held since graduation. Star present position : Type of In what type Name of organization or hospital City State Dates position held of service Priorie St Jusiphi It Louisua My 134-33 genera duly him h Grodusin us marine Leurnau , Ry duty 38-41 genera generor duty Booth Hag Cor. Ky Hosp 4443 duey 15. Availability : By applying for enrollment I signify my desire to help meet the emergency nursing needs of my country and to have my credential record in order so there may be no delay in assignment when I volunteer or am called. I understand that this may mean service with the Army or Navy, or with the Red Cross in case of disaster. I realize that acceptance of assignment is voluntary and that my ability to respond to a call to service will depend on the circumstances at the time the call is received. For military assignment I prefer Army Nurse Corps Navy Nurse Corps ; either as needed I will be available for service about Feb / 1943 Sunshine (Mdnth) E-warren (Day) (Year), (Date of application) (Signature of applicant) SPACE BELOW TO BE FILLED IN BY COMMITTEE PLEASE DO NOT USE THIS SPACE The recommendations of the Local Committee on Red Cross Nursing Service should be indicated below, over the signature of at least two members of the committee. APPROVED NOT APPROVED Name of committee Date received by committee No. Date acted upon by committee (Date enrolled) FEB 17 1943 AT 6%,

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    "ocrText": "12. Professional affiliations:\nOf what State nurses' association are you a member Ky ? try\ndy State (Name) Board of new (Title and organization) Extern. 604-5-314 (Address) Lanicuary\nTo whom and when did you last pay your dues Jan 1943- (Year)\nIf not a member, when and where do you plan to join ?\n/\nIn\nwhat State are you registered ? ty\nWhat year? 1934 Registration number 5104\nIf not registered, when and in what State\nwill you take your State board examination ?\n(State)\n(Date)\n13. Present position :\nField of nursing\nMajor responsibilities\nInstitutional\nPrivate duty\nAdministration\nGeneral duty\nPublic health\nOther (specify below)\nSupervision\nPrivate duty\nIndustrial\nTeaching\nOther (specify below)\nT\ne\n14. Give in chronological order positions held since graduation. Star present position :\nType of\nIn what type\nName of organization\nor hospital\nCity\nState\nDates\nposition held\nof service\nPriorie\nSt Jusiphi It Louisua My 134-33\ngenera duly him h Grodusin us marine Leurnau , Ry\nduty\n38-41\ngenera\ngeneror duty Booth Hag Cor. Ky\nHosp\n4443\nduey\n15. Availability :\nBy applying for enrollment I signify my desire to help meet the emergency nursing needs of my country and to have\nmy credential record in order so there may be no delay in assignment when I volunteer or am called. I understand\nthat this may mean service with the Army or Navy, or with the Red Cross in case of disaster.\nI realize that acceptance of assignment is voluntary and that my ability to respond to a call to service will depend\non the circumstances at the time the call is received. For military assignment I prefer Army Nurse Corps\nNavy Nurse Corps\n;\neither as needed\nI will be available for service about\nFeb\n/\n1943\nSunshine (Mdnth) E-warren (Day) (Year),\n(Date of application)\n(Signature of applicant)\nSPACE BELOW TO BE FILLED IN BY COMMITTEE\nPLEASE DO NOT USE THIS SPACE\nThe recommendations of the Local Committee on\nRed Cross Nursing Service should be indicated below,\nover the signature of at least two members of the\ncommittee.\nAPPROVED\nNOT APPROVED\nName of committee\nDate received by committee\nNo.\nDate acted upon by committee\n(Date enrolled)\nFEB 17 1943\nAT\n6%,"
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