Participant Info

Membership Number
4108
Salutation
Mr
First Name
Jim M
Middle/Maiden/Previous
Last Name
Wegner
Address 1
2017 36th St
Address 2
City
Two Rivers
Zip Code
54241
Phone
920-794-7586
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