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[[preprinted]] Application - Bladensburg Union. City or Town: State: Month: Date: Year: ^[[Bladenburg Md. Oct 12. 1908]] I hereby make application for admission into the Bladenburg Union. Age last birthday ^[[32.]] years. [[signature]] ^[[Garfield Bailey.]] [[/signature]] Name of Applicant ^[[$1 bal due $4. Paid W. E. B.]] [[double line]] This certifies that the above named applicant is in reasonably good health. ^[[Not given]] , M. D.