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^[[Join for $500]] [[preprinted]] Application-Bladensburg Union. CITY OR TOWN: STATE: MONTH: DATE: YEAR: ^[[Bladensburg Md. November 2 [[strikethrough]] 7 [[/strikethrough]] 2 [[strikethrough]] 1883 [[/strikethrough]] 1925 I hereby make application for admission into the Bladensburg Union. Age last birthday ^[[42]] years. ^[[$1.00]] [[signature]] ^[[Sarah Ellen Green.]] [[/signature]] ]Name of Applicant. [[double line]] This certifies that the above named applicant is in reasonably good health. [[signature]] ^[[H. T. Willis]] [[/signature]] , M.D. [[/preprinted]]