| Regimental number | 27621 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Analytical chemist |
| Address | Stawell, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, A B Ford, Union Bank, Stawell, Victoria |
| Enlistment date | 3 May 1916 |
| Date of enlistment from Nominal Roll | 3 June 1916 |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 3, Reinforcement 4 |
| AWM Embarkation Roll number | 25/91/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A30 Borda on 20 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Field Artillery Brigade |
| Fate | Returned to Australia 4 July 1919 |
