| Regimental number | 6/2976 |
| Address | c/o Grant and Seaton, Timaru |
| Marital status | Single |
| Next of kin | Mother, Mrs Margaret Clark, 21 Glen Road, Mornington, Dunedin |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 7th Reinforcements, Canterbury Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on |
| Miscellaneous details | Nominal Roll Vol. 1: Canterbury Infantry Batln/Seventh |