Participant Info

Membership Number
4173
Salutation
Mrs
First Name
Polly K
Middle/Maiden/Previous
Last Name
Wagner
Address 1
9904 Colonnades Place
Address 2
City
Louisville
Zip Code
40299
Phone
502-231-0858
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