This transcription has been completed. Contact us with corrections.
[[preprinted]] Application - Bladensburg Union. ^[[1928]] City or Town : State : Month : Date : Year : ^[[Bladensburg Md. June 15 1893.]] I hereby make application for admission into the Bladensburg Union. Age last birthday ^[[(35) thirty five]] years [[signature]] ^[[Mabel J. Mason]] [[/signature]] Name of Applicant. [[double line]] This certifies that the above-named applicant is in reasonably good health. [[signature]] ^[[Geo H Gates]] [[/signature]] , M. D. [[/preprinted]]