Participant Info

Membership Number
1042
Salutation
Ms
First Name
Diane Lagoon
Middle/Maiden/Previous
Last Name
Clark
Address 1
1307 E Fairway Drive
Address 2
City
Eagle
Zip Code
83616
Phone
208-939-1923
Work Code #
Date of Birth
Date of Death
Deceased At Join?
Comments
Name/Location of Company Worked
Dates of Work
Type of Work
Rosie Name if Rb or Rv
Is/Was Rosie a member of ARRA?
Contact Name (Deceased Rosie Contact)
Contact Email Address
Contact Phone Number