| Regimental number | 4772 |
| Place of birth | Tamworth New South Wales |
| Religion | Church of England |
| Occupation | Farm labourer |
| Address | Carthage Street, Tamworth, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, T W Church, Carthage Street, Tamworth, New South Wales |
| Enlistment date | 31 August 1915 |
| Date of enlistment from Nominal Roll | 18 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 55th Battalion |
| Fate | Returned to Australia 2 May 1918 |
