Viewing page 2 of 236

This transcription has been completed. Contact us with corrections.

^[[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]]