Participant Info

Membership Number
1170
Salutation
Ms
First Name
Carol
Middle/Maiden/Previous
Last Name
Smith
Address 1
24880 Suttle Road
Address 2
City
Elmira
Zip Code
97437
Phone
541-935-0123
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