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

Delaware 'Avenue Baptist Church - Buffalo, N. Y. 4- 19- 08

BBy Baptism

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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 a lso)

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TELEPHONES

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

Home _______ _

Business Address

Date _A~p~r_i_l_l~9~'-1~9_0_8______

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