| Regimental number | 6787 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Portland, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs. Maud Bairstow, Moorina, via Launceston, Tasmania |
| Enlistment date | 19 August 1915 |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 1, Reinforcement 15 |
| AWM Embarkation Roll number | 22/11/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Orsova on 11 March 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Engineers Details |
| Fate | Returned to Australia 25 May 1917 |
