BAPTIST BIOGRAPHY DATA FORM

Please read carefully the Instruction Sheet and then list the appropriate informationas it directs.

,~hLa Q di1. NAME ~ ~..ek (SeCt:(jGive full names. For a married woman please put maiden name in parentheses.

IEXAMPLE: Cole, Mary Ann (Smith j.]

2. BIRTH J1.RA/]ILd)--r~ 19~ --I-rn~~sr:L...:!.ate-,l!-r- --,-J__"'~'=-Da-'<-f.,--)=-rg'_

DEATH ----c:-----..,,..._----:

3. PARENTS~uz~~~~~~~~~~~~~~~~~~~~U4~~

4. BROTHERS(Living or deceased) Number.

(Living or deceased)(~)

NumberList full names and year of birth5. SISTERS

~ U~R~ lqDD~la,~ ~A I q 617- ~ I e» 76. CHILDHOOD RESIDENCE: (Please list each residence of 3 years duration or more, up

to the time of the 18th birthday)Type of Community Post Office County State DatesRural (R); town under2500 pop. (T); city 2500or more pop. (C). Check one.

R ~ T D C D ~~~~~_L_u_v~~~~~'!:f&Lr!Jd.:.&:e,...JL.\.J'~~

R I32i T D C D~~~~~u.l£q:l_~J:JJ~!a.._J~~ ---R D T D C D _R D T D C D - ----

7. EDUCATION:Grammar school: Graduate? Yes ( ) No (vJ Year graduated _High school: GradUad Yes ~ ) Year graduated

School attended: ~Name) ~~~_:...., -.1!.9t~(s~t:Xt~")---(Whether graduate or not; if more than one was attended, show the last one.)

College: Years attended: None (V) One ( ) 2-3 (Whether graduated or not, list college(s) attended:

Graduate ((EXAMPLE: 1935·'38)

(State)(Place) (Years attended) (Degree)(Name)

(Name) (Place) (State) (Years attended) (Degree)

Graduate-level: List college(s), seminary(ies), etc. attended; earned degrees(Name) (Place) (State) (Years attended) (Degree)

8. SPECIAL AWARDS OR RECOGNITION RECEIVED: (Honorary degrees, such as:D.D. Howard College, 1948; citations, such as: Who's Who in American Colleges andUniv~rsities, 1939; honorary positions, such as: "Man of the Year"-Pryor, Okla., 1943;etc.)

9. MARITAL INFORMATION:Spouse

(1)~~~~~~~~~~~~==~~~~~~~~~~~~1(2

Ie;

--....... Number of children (~). List their full names and birthdates: (an example of a married~ ~ daughter would be: Mrs. John Alan (Mary Lou) Ross, 3-7-1918)

~~~~,:t~;£:1l!=';,f~~~~·!!U,Jg.110. VOCATIONAL HISTORY (List all vocations, occupations, trades, or professions

engaged in for two or more years) ~4a '¥ ~~VtUj.~ d ~

~ll. RELIGIOUS EXPERIENCE: ~~UlIr.-'t~Conversion I q ,9 :J :J_.tj. Baptism /J.. / q t/l Y>I~ fA 1.J.. Ea. ' r;;I

(Oate) (Age) (Dater lChtlrChld ~tion of Church)

List any church, other than Baptist, with which formerly affiliatedOrdained as: Minister ( ) Deacon ( ) Other _

(Church) (Place)(Date ordamed) (State)

12. LOCAL CHU~CH ACTIVITY, UNSALARIED (Place the number of years service, inthe space provided, for each office ever held.)

Gen. Supt .• Dept. Supt., Teacher. List below other Other OfficesDirector, Director, Counselor, offices or service,

(give number of years service)President Circle Chm. Sponsor, such as: Sec.,Leader Assoc. Supt., etc.

Deacon - Ch. Treas. -Trustee - Ch. Library -Usher -- Ch. Recreation __

S.S. Ch. Clerk - Choir Mem. --Other - Choir Direc. ---

T.U. Ch. Committee Chm.

V.B.S.List completed Study Course diplomas(Indicate related organizations, suchas: S.S., T.U., etc.)

Broth.

W.M.U.

13. DENOMINATIONAL SERVICE, UNSALARIED. (Please list positions held in Baptistassociations, convention? (state or Southern), national a!1d.world-wide organizations,such as; moderator, president, clerk, trustee, board, commission or committee members;etc.)Example: S.S. Superintendent

(Position) (Organization, board, agency. etc.)Bethel Association Kentucky

(State)1942-1944

(Date)

(Position) (Church, agency, area, institution, place of service) (Date of service)

P[K) 1. pastor County Line Baptist Church, Turkey Creek, La. 1925-1929P D 2. mlsslOnar.):: Ogbomosho, Nigeria, W. Africa 1930-1952

14. TO BE FILLED OUT ONLY BY THOSE WHO ARE, OR HAVE BEEN, IN SAL-ARIED CHURCH-RELATED VOCATIONS. (Including pastors, denominational work-ers, missionaries, ministers of education and music, church secretaries, faculty membersor employees of Baptist institutions. agencies, etc.)TYPE AND LENGTH OF SERVICE: List all positions of such service with one ormore years of duration; check F (full-time) or P (part-time). Examples:

P D _P [J __P [J __P D _PD _P [J ---'='--- __ ---" _

P D _P [J _P [J _P [J _P [J _P [J _

FDF[!]

F[JF[JFDF[JF[JFDF[JF[JFDF[JF[JF[J

15. OTHER TYPES OF RELIGIOUS SERVICE: (In associations, assemblies, colleges, con-ventions (state or Southern), national or world-wide meetings, such as: speaker, musicdirector, committee chairman, etc.)

(Position) (Place of Service) (Da te of Service)

16. AUTHORSHIP (Include books, booklets, lesson courses or curriculum material, andtracts) (Book, item, etc.) (Publisher) (Date published)

17. CLUB OR GROUP MEMBERSHIP: (Service organizations, fraternal, P.T.A., Civic, etc.)List important positions of leadership held

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18. HOBBIES AND LEISURE INTERESTS:Favorite Others ---- _

19. PUBLIC SERVICE: (Military, educational, political, etc. not previously listed) _

DO YOU HAVE LETTERS, DIARIES,PHOTOGRAPHS, OR OTHER MEMENTOES????The Baptist Historical Collection would like tohave this material or be allowed to photocopy suchitems for permanent preservation here in theCollection. We establish personal collections by thename of the donor. Any donated materials relatingto the life and endeavors of our N.C. Baptistpastors and denominational leaders will bepreserved for future generations of Baptists. Toooften in our highly mobile society these items arethrown away or hastily discarded. They should bepreserved. Let us know if we can assist you withthe preservation of your personal papers. Phone(919) 825-9711, extention 277 collect.

The information for items # 1-19 has b en filled in b

Mailing address. '7 I

Sources used in compiling the mformation are: (Example: personal knowledge; minutes, Cal-vary Baptist Church, Wisner, La.; Court Records, Copiah County, Miss.; etc.)

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