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^[[1929]] [[preprinted]] Application - Bladensburg Union. City or Town: ^[[Bladensburg]] State: ^[[Md]] Month: ^[[Feb.]] ^[[July]] Date: ^[[23]] Year: ^[[1912.]] I hereby make application for admission into the Bladensburg Union. Age last birthday. ^[[seven - 7]] years ^[[Theodore Henry Mason.]] Name of Applicant. [[double line]] This certifies that the above-named applicant is in reasonably good health. ^[[Geo H Gates]], M. D. [[/preprinted]]