| Regimental number | 1830 |
| Place of birth | St James, Victoria |
| Religion | Church of England |
| Occupation | Farmer |
| Address | St James via Benalla, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, Joseph Church, St James via Benalla, Victoria |
| Enlistment date | 12 February 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Light Horse Regiment, 10th Reinforcement |
| AWM Embarkation Roll number | 10/18/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on 28 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Light Horse Regiment |
| Fate | Returned to Australia 25 August 1917 |
