Participant Info

Membership Number
3088
Salutation
First Name
Aiden Mathew
Middle/Maiden/Previous
Last Name
Simon
Address 1
3442 RUGER AVE
Address 2
City
Janesville
Zip Code
53546
Phone
317-383-6964
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