MembershipCards_S

__ Reg .___ 1624 _____ _)3_1:;_ei_r1gei:L_.:___ _H.:§cr.Y8Y. _}__ !__________________________ --·-···-···---··--- ______ --------------·--· 83 Hartwell Road, Buf . 16

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~ (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.

:JU By Baptism 4- 25- 09 D By Letter from ---- ---------------------------------

D By Christian Experience Method of my baptism: D By immersion

D By sprinkling

My name in full

(If married woman give first name also)

Address ----- - -------- ----------------- --- Zone_ _ _

TELEPHONES

Occupation

Home ________

Business Address Date April 2 5 1

1909

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