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 Assault Helicopter Company; 59th Infantry Platoon Scout Dog; 523rd Signal Battalion, 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)

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:
Specialty/MOS:
Primary Assignment:
Vietnam Unit:	(Select the lowest level unit in this list)
Company:
Platoon:
Squad:
Date Arrived:
Major Event:	Brief description of what happened, wounded in action, etc.
Date Departed:
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.)