If this is an update to an existing roster entry, enter only the information that needs to be updated. Otherwise, enter as much information as possible.
Last Name:
(Required)
First Name:
(Required)
Middle Name:
Nickname:
Rank:
SELECT
PVT
PFC
CPL
SP4
SGT
SP5
SSG
SFC
MSG
1SG
SGM
CSM
WO1
WO2
CW2
CW3
CW4
2LT
1LT
CPT
MAJ
LTC
COL
Other - Described in Comments
Specialty/MOS:
Primary Assignment:
SELECT
APC Driver
Armor Intelligence Specialist
Artillery Assistant Gunner
Artillery Crew Chief
Artillery FDC
Artillery FO
Artillery Gunner
Artillery Liaison Officer
Artillery RTO
Artillery Section Chief
Battalion Commander
Battalion Mess Sergeant
Battalion Surgeon
Battalion XO
Battery Commander
Battery XO
Chaplain
Chopper Pilot
Clinical Specialist
Communications Specialist
Company Clerk
Company Commander
Company XO
Cook
Combat Demolitionist
Door Gunner
Field First Sergeant
Fire Direction Officer
Fire Support Officer
First Sergeant
Heavy Equipment Mechanic
Jeep Driver
Liaison Officer
M-60 Machine Gunner
M-79 Grenadier
Mail Clerk
Medic
Medical Operations Assistant
Medical Platoon Leader
Medical Platoon Sergeant
Medical Specialist
Mortarman - 81mm
Mortarman - 4.2i
Motorpool - Driver
Motorpool - Maintenance Officer
Motorpool - Mechanic
Platoon Leader
Platoon Sergeant
Pointman
Property Book Officer
Quad-50 Machine Gunner
Recon
Rifleman
RTO
S-1 Personnel NCO
S-1 Personnel Officer
S-2 Intelligence Officer
S-2 Intelligence Specialist
S-3 Operations NCO
S-3 Operations Officer
S-4 Logistics Officer
S-5 Public/Civil Affairs Officer
S-6 Communications Officer
S-6 Communications Specialist
Scout Dog Handler
Services Platoon Leader
Squad Leader
Sniper
Supply Clerk
Supply Sergeant
Supply Specialist
Tank Bow Gunner
Tank Commander
Tank Driver
Tank Gunner
Tank Loader
Track Commander
Troop Commander
Truck Driver
Weapons Specialist
Other - Described in Comments
Vietnam Unit:
SELECT
11th Light Infantry Brigade
3rd Battalion, 1st Infantry
6th Battalion, 11th Artillery
26th Engineer Battalion (Combat)
Echo Troop, 1st Cavalry
174th Aviation Company
Other - Described in Comments
(Select the lowest level unit in this list)
Company:
SELECT
HHC
Alpha
Bravo
Charlie
Delta
Echo
174th Assault Helicopter
174th Avn Co
HHB
Alpha Battery
Bravo Battery
Charlie Battery
Delta Battery
HSB
NA
Other - Described in Comments
Platoon:
SELECT
HQ
CP
1st
2nd
3rd
4th or Weapons
Commo
Medical
Recon
4.2 Mortars
Gun 1
Gun 2
Gun 3
Gun 4
Gun 5
Gun 6
59th Inf Plt Scout Dog
NA
Other - Described in Comments
Squad:
SELECT
1st
2nd
3rd
4th
Date Arrived:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
1967
1968
1969
1970
1971
1972
Major Event:
Brief description of what happened, wounded in action, etc.
Date Departed:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
1967
1968
1969
1970
1971
1972
Home Town:
Home State:
Current Information: Your address and phone number will not be available for public viewing on the Hill 4-11 Roster Database . Your address and phone number
will only be used for official business, such as newsletters, etc. Input your email address if you want others, such as your long lost buddies, to be able to contact you.
Address Line 1:
Address Line 2:
City:
State:
ZIP:
Phone Number:
Email Address:
Optional - Your Email Address will be available for public viewing (If this form is for your roster entry, input your email address only)
Current Occupation:
Comments:
Your Name:
(Required whether this is your personal registration or you are registering someone else.)
Your Email Address:
(Required whether this is your personal registration or you are registering someone else.)