Participant Info

Membership Number
1999
Salutation
Miss
First Name
Jordan Taylor
Middle/Maiden/Previous
Last Name
Naja
Address 1
1339 Eubanks Ave
Address 2
City
East Point
Zip Code
30344
Phone
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