51 Morton Road.

Have

Referees

Give the names and ad-

dresses of two referees They should be respon. sible persons who know

you well, either

private life or pro-

1. Name Miss Gload R. R. 6. Matrow, F;

Address Military Orthopaedic Hospital.

in

Occupation

fessionally; and one

at least should be well acquainted with in private life.

you

The

Duca

ame

Road.

Shepherds Bush

sumes of distinguished 2. Name Miss V. The bonichof.

persons

not be

given unless they really

know you well.

Address

COLONIAL NURSES.

273

STATEMENT for the information of the Secretary of State for the Colonies, and for record

un

Friis q.8. Atyatt.

in the Colonial Office, respecting

who is an applicant for the post of Nurse

Matron

in the Colony of

QUESTIONS.

ANSWERS.

Sussex.

Occupation

Nie.

b. Will you be good enough to state how long you have

been acquainted with the applicant?

ta

Testimonials.

(rive the name, address, and occupation of the waiter of each of your testimoniala, Copies certified by the Colonial Nurs

Association must be sent for record in the Colonial Office. The Copies may be either in M.S. or in print; and it i desirable, though not absolutely necessary, that they should be on foolscap paper not larger than this form.

From what circumstances does your knowledge of her

nise ?

1. From March 1915 1918

2. During Training

(644x)

3. While you were acquainted with her was she

(a) honest?

3.

住。

(b) sober?

D.

(c) generally well conducted?

Yes

Was her health good?

Yes.

If she has been employed under you, will you state the

nature of her duties, and how she discharged them?

bracing as

5. Three

yealo Probationer.

Will you state the cause of her leaving whether by 6.

voluntary resignation, dismissal, or otherwise f

Finished Training

(TURN OYEE,

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