o ~-r;'7ci1 P1:.i( *33',J:f~ .....Re.g_.__25.79..........Schl.e.ge_l,,..J:Irs..,....A ....Curtis...(Flore.nce.}...SLh.-c.5 ~ 7 / 242 Linden Avenue, Buf . 16 Home BE to13 Cf 6 0/...0 ~ry --;e..,t t ery,_ ' I' l/-1 s· C ~ (Applicant will please not write in spaces above this heavy line) Bus.

D, e ~ 'D /Io j 7 ~

I WISH to enter into active Christian Service by becoming a member of

Delaware Avenue Baptist Church - Buffalo, N. Y.

0 By Baptism 0 By Letter from ---------------------------------– Fonner] y :nember Hu dsan Street B"o±.i st

Letter from Central Presbvterian

[X By Christian Experience

Method of my baptism : 0 By immersion

0 By sprinkling

My name in full

(If married woman give first name also)

Address --------------------------------- Zone__


Occupation -------------------------–

Home ______ _

Business Address Date ___ D_e_c_e_m_b_e_r_l_2~,_1~9_2~3_____


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