Participant Info

Membership Number
1769
Salutation
Mr
First Name
Jim L
Middle/Maiden/Previous
Last Name
Benner
Address 1
1675 Country Club Circle
Address 2
City
Woodburn
Zip Code
97071
Phone
541-367-7572
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