~ (Applicant will please not write in spaces above this heavy line)

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

0 By Baptism Delaware Avenue Baptist Church - Buffalo, N. Y. 4- 8-28 0 By Letter from ----------·--- - --D"-"'r'--0'""'-+p-'-+p--"c: .......... cl_-_ _.c__._hL>.,..,_,1,_r-'=-'---'-b-'------"'o=c::h_,__._·CY)...._,_,___ _ ,11q/7e 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_ _


Home ________

Date _ A~D~, r_il=-_8~,_1=9~2_8_______


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