A.
386
C
Application for Employment as Matron or Nurse in the Colonies.
1836
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, 16 JAN 20
Ne in full
Date of Application
Profession or Occupation
Address
Father's Name
Christiner Euphemin Malaish.
12. Jam: 1909.
Stospital trusse
27. Juen Annés Sah, London S.W.
Profession or Occupation
Address ...
If dead, his Name and Profession
should nevertheless be given.
Day and year of birth...
Place of birth
Cames In Leishy James
Farmer & Gentleman.
Dead,
15 May 1876.
Perth Scotland.
Whether single, married, or a widow
Number of children
Sons
Aged respectively
Age last birthday 33.
Singlo
Daughters
27
21
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.
Professional qualifi- cations, and the place and date at which each Was obtained
completion of edu-
At Home,
hurse, Western Fever Hospital London sur
8. Feb. 18.98. to 26. Dec: 1400.
also
nurse. Eestminster troopitur Sondon Sur 28. Dee: 1900 to 1904
28. April.
Go
Comment Hospital Colombo Ceylon,
Employment from from 19th June 1904. to march 19th 1908.
3. years agreement. Stayed on 9 months bing asked to do so by Cylon Dovenonsu
cation to present time
Mention each position
between which you held
it, and the cause of
longer Govenment
hold by you, the dates Private nursing to Westminster Traming School Westminai Hospital. 24. Jum Anne's Lah Sex July 21, 1908. & mouthis
leaving; arud what
salary Fon are now receiving.
Appointment desired
TI
you do not apply for a particular appointment, you should state to what Colonies you would go, aud what is the lowest salary that you would accept.
WB & L (250)-10461--500-7-3
(J. 6.)
₤40 (Salam) with percentage
Hong Kong Cuich Depilat.
[TURN OVER.