Participant Info

Membership Number
3592
Salutation
First Name
Edward R
Middle/Maiden/Previous
Last Name
Bloomer
Address 1
529 Route 49
Address 2
City
Coxsackie
Zip Code
12051
Phone
518-945-1570
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