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- MAN 117: -
Application I - (Continued)
PROPERLY SIGNED AND ENDORSED, ACCORDING TO
ARTICLE V, Sect. 2
FORM 1, - (Continued.)
I am not a member of any church, excepting.....
Church of Christ, Scientist, at....
Yours in Truth and Love,
(Note: the phrase, "excepting...Church of Christ, Scientist, at"
is crossed out in the form that appears in the Manual.)
Name. Mrs. Jennie W. Field, C.S.
Street and Number. Forest St.,
Town or City. Chicago,
State. Ill.
Date. Jan. 2nd, 1901.
I cordially approve this applicant.
(a). James B. Brown, C.S.D.
Countersigned by....
DO NOT DETACH.
TO THE APPLICANT: Name. Mrs. Jennie W. Field, C.S.,
Please fill out the Street and Number. Forest St.,
following for the use Town or City. Chicago,
of the Treasurer of State. Ill.
the Church:
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