| Regimental number | 1515 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | London |
| Address | Rockleigh PO, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs M J Churchill, Rockleigh P.O., New South Wales |
| Enlistment date | 28 August 1914 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, H Company |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 20 October 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 17 August 1915 |
