MembershipCards_S

~ ___y/ ___ JEANETTE __ SWENSON _________________ __ ----------------- ------------------------------- ----------

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Home882-2178

77 Hodge Avenue Buffalo, N.Y. 14222

Bus.

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

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

Delaware Avenue Baptist Church - Buf lo, N. Y.

D By Baptism D By Letter from ---- - -------------------------- -------

D By Christian Experience Method of my baptism : D By imm ersion

D By sprinkling

My name in full

(If married woman give fi rst name also)

Address - --- ----------- --------- - -------- - -- Zone___

TELEPHONES

Occupation

Home _____ ___

Business Address

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