Horne LU IJhJ 7'~~,. 9i4r Bus.

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

[X By Baptism Delaware Avenue Baptist Church - Buffalo, N. Y. 3-3-07 D By Letter from ----------------------------------- ,0, ,:.d, D By Christian Experience Method of my baptism : 0 By immersion D By sprinkling

My name In full ----------------------------------- (If married woman give first name also)

Address --------------------------------- Zone__ Occupation _L_e_t_t_e_-r_ _cC:...:a'-'..r_:.._i"=i:...:e:...:r:__________________ TELEPHONES

Horne _______

Business Address

Date __ M_a_r_c_l_1-'J"--"-,_l.,__9_0__,7________


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