INQUIRY BLANK
OF THE FIELD DEPARTMENT FOR THE
EXTENSION OF ORGANIZED CHARITY IN THE UNITED STATES.
NOTE-Societies are requested to fill in all blanks as fully as possible.
Street
Re. Case No.
City
State
Date
Dear Friends:
Will you kindly co-operate with us in securing the information asked below regarding:-
Woman's First Name
..
aurname
Man's First Name
(.
Age
CHILDREN
.)
* *****
Name
Name
Nome
(.
..
Name
Name
Nama
Name
Address
Prese
CONDITION OF FAMLY
r pature of distress in sutticient detail
at least summarize the situation.
r relation.
Nams of person
Address
Connection
be interYiewed
Definite request stated
Thanking you in advance for your help, we remain,
Yours very truly,
nation is needed
t the earliest possible moment.
Name of Socicty.
Fer....
(I more space is needed, use reverse side.
