Participant Info

Membership Number
3246
Salutation
First Name
Nick
Middle/Maiden/Previous
Last Name
Scott
Address 1
454 Cedar Street
Address 2
City
Bourbon
Zip Code
65441
Phone
573-259-9689
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