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FORM 1045 REV. OCT. 1943 AMERICAN RED CROSS NURSING SERVICE ANNUAL QUESTIONNAIRE-1944 Red Cross If you have changed your last name Badge number 17500 since contacting us, please check here. Name in full Stanfield Agnes Hannah Tel. No. (last) (first) (middle) If married, give maiden name von Kurowsky- Date of birth Jan.5-1892- Marital status married. Husband's name William S.Stanfield jon (single, married, widowed, divorced) Permanent address 80 (street) East main (city) st middletown. (county) Orangeco (state) n.e.f Present address 149 East 40th st. newyork 16. N.Y- (street) (city) (county) (state) Notify national headquarters immediately if you change your address. Give name and address of nearest relative or friend in the United States: com. Stanfield p cm'/c U.S.N. Camp Bradford-nortail.va - husband . (name) (address) (relationship) 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 Amer. Red Cross Blood Donor's Service- 37th st. -5th ave. new york-n.y. 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? (specify date) Not available, for the following reason? over age (specify) Do you have any dependents under 14 years of age? Yes No AVAILABILITY FOR SERVICE WITH CIVILIANS If qualified and not already doing so, will you be available: - To teach Red Cross Home Nursing classes? adidas To teach volunteer nurse's aides? To take a Red Cross emergency assignment? efes- To serve overseas caring for civilians? - Have you ever served with the Red Cross in a disaster? Yes No 2/8/44 If yes, specify type of disaster

Document source description

This is Agnes Stanfield's completed annual questionnaire from 1944 in regards to the Nursing Service at the American Red Cross.

Page data

Page
2
Source index
0
Type
photo
Media ID
18a45af90ec6a075
Size
unknown

Document data

ID
6706125
Core
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Type
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Context sent to Scholar

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Document source extras
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Page context
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    "ocrText": "FORM 1045\nREV. OCT. 1943\nAMERICAN RED CROSS\nNURSING SERVICE\nANNUAL QUESTIONNAIRE-1944\nRed Cross\nIf you have changed your last name\nBadge number 17500\nsince contacting us, please check here.\nName in full Stanfield Agnes Hannah\nTel. No.\n(last)\n(first)\n(middle)\nIf married, give maiden name von Kurowsky-\nDate of birth Jan.5-1892-\nMarital status married.\nHusband's name William S.Stanfield jon\n(single, married, widowed, divorced)\nPermanent\naddress 80 (street) East main (city) st middletown. (county) Orangeco (state) n.e.f\nPresent address 149 East 40th st. newyork 16. N.Y-\n(street)\n(city)\n(county)\n(state)\nNotify national headquarters immediately if you change your address.\nGive name and address of nearest relative or friend in the United States:\ncom. Stanfield p cm'/c U.S.N. Camp Bradford-nortail.va -\nhusband .\n(name)\n(address)\n(relationship)\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\nAmer. Red Cross Blood Donor's Service-\n37th st. -5th ave. new york-n.y.\nIf not employed, what type of nursing would you prefer to render?\n-\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?\n(specify date)\nNot available, for the following reason? over age\n(specify)\nDo you have any dependents under 14 years of age? Yes\nNo\nAVAILABILITY FOR SERVICE WITH CIVILIANS\nIf qualified and not already doing so, will you be available:\n-\nTo teach Red Cross Home Nursing classes?\nadidas\nTo teach volunteer nurse's aides?\nTo take a Red Cross emergency assignment? efes-\nTo serve overseas caring for civilians?\n-\nHave you ever served with the Red Cross in a disaster? Yes\nNo\n2/8/44\nIf yes, specify type of disaster"
}