Viewing page 16 of 236

This transcription has been completed. Contact us with corrections.

[[preprinted]] Application-Bladensburg Union.

CITY OR TOWN:|STATE:|MONTH:|DATE:|YEAR:| 
[[/preprinted]] 

[[dotted underline]] Baltimore| Md| January| 25,| [[strikethrough]] 1908 [[strikethrough]] 1928 [[/dotted underline]] 

[[preprinted italics]] I hereby make application for admission into the Bladensburg Union. 
Age last birthday [[dotted underline]] ^[[Twenty]][[/dotted underline]] years. [[/preprinted italics]] 

[[dotted underline]] ^[[signature]] Samuel Cudley. [[/dotted underline]] [[/signature]][[preprinted italics]] Name of Applicant. [[/preprinted]] [[/dotted underline]] 

[[double line]]

[[preprinted italics]] This certifies that the above named applicant is in reasonably good health. [[/preprinted italics]]

[[dotted underline]] ^[[signature]] Geo. H. Gates [[/signature]], M.D. [[/dotted underline]]