MembershipCards_S

R- 4179-

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

Delaware Avenue Baptist Church - Buffalo, N. Y.

1211 By Baptism 0 By Letter from ------------------------------ -----

0 By Christian Experience Method of my baptism : /2g" By imfllersion

0 By sprinkling

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My name in full

(If married woman give first name also)

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Occupation ---~S~t..... 1 .. 1~cl~~e.~a~ ,--- --------------

TELEPHONES

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Business Address

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Date

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