Participant Info

Membership Number
168
Salutation
Mrs
First Name
Cathy Jackson
Middle/Maiden/Previous
Last Name
Avischious
Address 1
6108 Flowergate Lane
Address 2
City
Waxhaw
Zip Code
28173
Phone
719-282-3101
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