Participant Info

Membership Number
2593
Salutation
Mrs
First Name
Helen Jenean
Middle/Maiden/Previous
Last Name
Fack
Address 1
19131 E Hwy 28A Unit B
Address 2
City
Claremore
Zip Code
74017
Phone
918-341-6345
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