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

Delaware Avenue Baptist Church - Buffalo, N. Y.

D By Baptism 112t· By Letter from ------.-/d.=~c.;.~"". /4i.c.c...,C--~_.~......,~"9,,/?=0.=ci..,;.,J=' _ ,_t;;""ld_"'"..,/44('.= -"''4........,,...'------- - ------ - – NiC~u J Y'od · 0 By Christian Experience

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Method of my baptism: [H'By immersion

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My name in full

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TELEPHONES

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Business Address

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