Roster

Hill 4-11 Roster Database Registration/Update Form

If you choose not to create a User Id and password for the Hill 4-11 Roster Database to enter your roster information, you can enter your information in the following Hill 4-11 Roster Database Registration/Update Form, and the webmaster for this web site will enter your information into the Hill 4-11 Roster Database for you. You can also use this form to register or update the information for someone else who served with the 3rd Battalion, 1st Infantry or one of its supporting units during the Vietnam War. (Delta Battery, 6th Battalion, 11th Artillery; 26th Engineer Battalion; E Troop, 1st Cavalry; 174th Aviation Company; etc.)

Please use the following form to input a new submital or update to the Hill 4-11 Roster Database:

Is this a self-registration? Yes No (Required)

Last Name:	(Required)
First Name:	(Required)
Middle Name:
Nickname:
Rank:
Specialty/MOS:
Primary Assignment:
Vietnam Unit:
Company:
Platoon:
Squad:
Date Arrived:
Major Event:	Brief description of what happened, wounded in action, etc.
Date Departed:
Home Town:
Home State:
Current Information: Enter only the information to be made public on the Hill 4-11 Roster Database at this web site.
Address Line 1:
Address Line 2:
City:
State:
ZIP:
Phone Number:
Email Address:	(If this form is for your roster entry, input your email address only)
Current Occupation:
Comments: