Participant Info

Membership Number
3431
Salutation
First Name
Dan
Middle/Maiden/Previous
Last Name
Lagoon
Address 1
290 N Plainview Rd
Address 2
City
Anderson
Zip Code
64831-1446
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