| Regimental number | 3782 |
| Place of birth | Prahran Victoria |
| Religion | Church of England |
| Occupation | Traveller |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, David Coventry Manor Street, Middle Brighton, Victoria |
| Enlistment date | 25 June 1915 |
| Rank on enlistment | Acting Sergeant |
| Unit name | 21st Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A69 Warilda on 8 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 21st Battalion |
| Fate | Returned to Australia 5 July 1917 |