Participant Info

Membership Number
12
Salutation
Mrs
First Name
Michelle D Nicki
Middle/Maiden/Previous
Last Name
Brown
Address 1
13738 Strong Hwy
Address 2
City
Strong
Zip Code
71765
Phone
870-797-7644
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