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the
work
bony see
Badge # 6620
7/21/44
EAF
Last
FORM 1045
REV. OCT. 1943
AMERICAN RED CROSS
NURSING SERVICE
ANNUAL QUESTIONNAIRE-1944
Red Cross 6620
If you have changed your last name
Name in full WATERbuRY Rith ChRistian7
Badge number
since contacting us, please check here.
Tel. No.
none
(last)
(first)
(middle)
If married, give maiden name
Date of birth Ock. 14, 1881.
Marital status
married, not widowed, any divorced) at Present -) serving ax Camp Clastime Exchange
Husband's name
(single,
Permanent address
(city)
Coup
Present address
2101 (street) Elliot ST.Alexandria (county) La
(street)
(city)
(county)
(state)
Notify national headquarters immediately if you change your address.
a
Give name and address of nearest relative or friend in the States:
miss Helen Beers
(name)
Jth
220 Principal United House are New (relationship) yood My
Are you employed in nursing at the present time? Yes
No
If employed, check the type of work you are doing and fill in below the title of your position and the name
and address of the agency or institution:
Institutional
Public Health
Industrial
Private Duty
Other
Camp Claibone Director Exchange - Camp dailborne, La
x
Personnel
If not employed, what type of nursing would you prefer to render?
IT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND
ANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX
AVAILABILITY FOR SERVICE WITH THE ARMED FORCES
Requirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.
For assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She
may be single or married, but if married she must have no dependents under 14 years of age.
If eligible and not already in service with the armed forces, are you:
Immediately available?
Available in the near future?
Not available, for the following reason ? am in Cirlian more M for
(specify date)
(specify)
Nox
Exchange
Do you have any dependents under 14 years of age? Yes
AVAILABILITY FOR SERVICE WITH CIVILIANS
If qualified and not already doing so, will you be available:
To teach Red Cross Home Nursing classes
To teach volunteer nurse's aides?
To take a Red Cross emergency assignment?
To serve overseas caring for civilians?
Have you ever served with the Red Cross in a disaster? Yes
No
If Flood - 1924.
yes, specify type of disaster
Page data
- Page
- 3
- Source index
- 0
- Type
- photo
- Media ID
- 88516e6eda9c34bb
- Size
- unknown
Document data
- ID
- 2662441
- Core
- doc
- Type
- document
DTO data
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Document source extras
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Page context
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"ocrText": "W\nthe\nwork\nbony see\nBadge # 6620\n7/21/44\nEAF\nLast\nFORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross 6620\nIf you have changed your last name\nName in full WATERbuRY Rith ChRistian7\nBadge number\nsince contacting us, please check here.\nTel. No.\nnone\n(last)\n(first)\n(middle)\nIf married, give maiden name\nDate of birth Ock. 14, 1881.\nMarital status\nmarried, not widowed, any divorced) at Present -) serving ax Camp Clastime Exchange\nHusband's name\n(single,\nPermanent address\n(city)\nCoup\nPresent address\n2101 (street) Elliot ST.Alexandria (county) La\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\na\nGive name and address of nearest relative or friend in the States:\nmiss Helen Beers\n(name)\nJth\n220 Principal United House are New (relationship) yood My\nAre you employed in nursing at the present time? Yes\nNo\nIf employed, check the type of work you are doing and fill in below the title of your position and the name\nand address of the agency or institution:\nInstitutional\nPublic Health\nIndustrial\nPrivate Duty\nOther\nCamp Claibone Director Exchange - Camp dailborne, La\nx\nPersonnel\nIf not employed, what type of nursing would you prefer to render?\nIT IS IMPERATIVE THAT YOU READ CAREFULLY THE QUESTIONS BELOW AND\nANSWER BY PLACING A CHECK IN THE APPROPRIATE BOX\nAVAILABILITY FOR SERVICE WITH THE ARMED FORCES\nRequirements: For assignment to the Navy Nurse Corps, a Red Cross nurse must be physically fit, single, and under 40.\nFor assignment to the Army Nurse Corps, a Red Cross nurse must be physically fit and under 45. She\nmay be single or married, but if married she must have no dependents under 14 years of age.\nIf eligible and not already in service with the armed forces, are you:\nImmediately available?\nAvailable in the near future?\nNot available, for the following reason ? am in Cirlian more M for\n(specify date)\n(specify)\nNox\nExchange\nDo you have any dependents under 14 years of age? Yes\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\nTo teach Red Cross Home Nursing classes\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment?\nTo serve overseas caring for civilians?\nHave you ever served with the Red Cross in a disaster? Yes\nNo\nIf Flood - 1924.\nyes, specify type of disaster"
}