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{
    "localId": "6706165",
    "label": "American Red Cross Service Application Form",
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{
    "id": "6706165",
    "sourceUrl": "https://catalog.archives.gov/id/6706165",
    "contentType": "document",
    "title": "American Red Cross Service Application Form",
    "description": "This item is a form filled out by Agnes von Kurowksy requesting one year of service.",
    "citationUrl": "https://catalog.archives.gov/id/6706165",
    "collections": [
        "Records of the American National Red Cross",
        "Historical Nurse Files"
    ],
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    "naId": 6706165,
    "levelOfDescription": "item",
    "productionDates": [
        {
            "day": 24,
            "logicalDate": "1926-06-24",
            "month": 6,
            "year": 1926
        }
    ],
    "recordType": "description",
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}

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    "seq": 2,
    "pageIndex": 0,
    "type": "photo",
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    "ocrText": "12. (a) Have you ever been physically examined for war service or life insurance? Upes jov was service\n(b) If so, state when, where, and, if possible, the name and address of the examiner Iss 1918-\n+\n1920\nin\nnew efork\n(c) Were you accepted or rejected ?\neyes\n13 What previous military service have you had? State name of organization with which you were enrolled, and in what branch of service,\nand dates of service\n14. (a) Would you enter foreign service?\nyes\n(b) In any country or countries where required?\nyes\n15. State briefly familiarity with foreign countries by residence or travel\nIu France about months\nm all-\nItaly gene 1918 - July 1919- -\nRounamid\nmay 1920 - Oct 1920 Teb-1921-0ch. 1921-\n16.\nAdvise what foreign languages you speak, read or translate, and degree of fluency French speaker-read\nfairly\n& translate fluently with moderate Germank fluence slegur Italian + Rammanian speake\n17. Give names and address of all patriotic, beneficial and social organizations to which you\nKnowledge\nBelleve almmue assae ashouse Hall 426 E.26 new York\n18. (a) Kind of service preferred\n(b) What do you consider your qualifications particularly fitting you for this service?\n19. lf an applicant for medical or dental service, state\n(a) What hospital service as interne\n(b) What hospital appointments at present\n(c) How long have you been in practice?\n(d) In what State are you licensed to practice?\n(e) Have you specialized in any branch? If so, what?\n(f) Are you a member of Medical Officers' Reserve Corps?\nRank\n20. (a) Would you serve without pay and defray all your necessary personal expenses?\nno.\n(b) If unable to serve as full self-sustaining volunteer, check following items you would require met by Red Cross :\nLiving expenses abroad (in cases of nurses and nurses' aides)\nLiving expenses prior to departure\nUniform and equipment, if any required\nTransportation in United States and return\nTransportation overseas and return\n(c) If Red Cross made adequate allowance for your expenses in the service, as per 20-b, what specific amount would you require in additon?\n(b) Length of term for which you could serve\n/. year\n(Subject to earlier termination in discretion of American Red Cross. Nurses must agree to serve one year, if required that long.)\nI hereby certify that the answers to the above questions are correct to the best of my knowledge and belief.\n(Signed) agner H. value Kurourty"
}