C. O.
A.
2331
NEC2
69
Application for Employment as Matron or Nurse in the Colonies. Reef O JUL 01
Form to be filled up by the Applicant herself, and sent to the Private Secretary to the Secretary of State, Colonial Office, London, by the Colonial Nursing Association.
Name in full
Date of Application
Profession or Occupation
Address
Father's Name
Harriet Maria Gourley.
1901.
June 23
Nurse (trained)
Moore House, Walkeringham, Gainsbro'
Henry Gourley.
Profession or Occupation
Address
If dead, his Name and Profession;
should nevertheless be given.
Farmer.
Moore House, Walkeringham, Gainsbro', Notts.
Day and year of birth...
Place of birth
Whether single, married, or a widow
Number of children
Age last birthday
January 15th 1874
Walkeringham
Single.
...
27.
Sons
Daughters
Age respectively
...
...
...
Education
Mention the Schools or Colleges at which you received your education, professional as well as general; and give in each case the date of entry and leaving.
Miss Shelton's Ladies' School, Northolms, Saime bro'
Professional qualifications, and the place and date at which each was obtained
Employment from the time you left school to the age of 21
Employment since completion of education to present time
2 years at home
Nursing since. Fever nursing 2 years at City Hospital, Coventry. General Nursing, St Mary's Hospital, Toddington. Surgical 3½ years. 6 months at Miss Barugo, now (by Brenton) Homes, High Beach, Loughton. Salary I received £30 a year.
Mention each position held by you, the dates in it and the cause of leaving; and what salary you are now receiving.
Appointment desired
If you do not apply for a particular appointment, you should state to what Colonies you would go, and what is the lowest salary that you would accept.
Hong Kong Gov. Hospital.
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