Participant Info

Membership Number
4531
Salutation
Mr
First Name
Richard Alan
Middle/Maiden/Previous
Last Name
Werth
Address 1
114 Attridge Rd
Address 2
City
Churchville
Zip Code
14428
Phone
585-734-2082
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