| Regimental number | 2017 |
| Place of birth | Broken Hill New South Wales |
| Religion | Baptist |
| Occupation | Student |
| Address | Georgetown, South Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, William Clark, Georgetown, South Australia |
| Enlistment date | 20 January 1917 |
| Rank on enlistment | 2nd Air Mechanic |
| Unit name | June 1917 Reinforcements |
| AWM Embarkation Roll number | 8/15/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 8 August 1917 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on 4 August 1917 |
| Rank from Nominal Roll | 2nd Air Mechanic |
| Unit from Nominal Roll | 4th Squadron, Australian Flying Corps |
| Fate | Returned to Australia 6 May 1919 |
