MembershipCards_S

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.....Fel ,... 4.1...............Ss:J..lmQn.,.... Mr.$. •.... Char.l.e.s... {Fr.anc L ................................

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~8 Daku La :S LI ee L, Baf. 16 Home ... R'"'J--+1""'9..,..8.._5 320 Washburn St ., Elgin, Ill. c/o Mr . Clarence Salmon

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!)r- (Applicant will please not write in spaces above this heavy line)

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

Delaware Avenue Baptist Church - Buffalo, N. Y.

D By Baptism IA By Letter from __ R_o_s_e_v_rm_o~d~A~v~e~n=u~e~P_r~e_s_b=y_t~e~r~i=a=n=+-,~T~o=l~e~d=oc....,,__O=h=i=o_______

0 By Christian Experience Method of my b a ptism : D By immersion

D By sprinkling

(If married woman give first name also)

Zone__

Address ------------- ---------------------

TELEPHONES

Occupation --------------------------–

Home ________

Business Address Date May S, 1915

Bus.

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