MembershipCards_S

_____Re_g_.___ 31_7_5_ ______ .S.we_e:t,, __ _ Hr.s__,____M,__N_,____(Ed.it.h) ____ 134 Chatham Avenue, I3uf . 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.

D By Baptism 1XJ By Letter from ___ N_o_r_t_h_P_a_r_l_(_B_a~p _t_i_s_t_M_e_r~g_e_r_______________

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

D By sprinkling

Address ----- ------------'f.::i,.._n,,___.n_,__,u,,,_,r._,S~l,,,_·n'-=g~h,.,,o"'m,_,,e"-),_______

Zone__

TELEPHONES

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

Home ________

Business Address

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Date

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