Vital Statistics Sheet - Association Of Graduates

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SUBMIT
SUBMIT
VITAL STATISTICS SHEET
The Association of Graduates maintains a folder (“Cullum File”) on every individual who ever attended USMA. This file becomes
more important for historical research every year. Completed Vital Statistics Sheets should be submitted by graduates every five
years. They are often the only source of information available on a graduate. Their completion and prompt return also insures
accurate and current biographical data in the REGISTER OF GRADUATES. Please keep a current Vital Statistics Sheet on file with
us. No one has access to your Cullum File without your or the Association Secretary’s prior approval.
Last Name
First Name
MI
Title or Rank
Cullum Number/Year
Residence Address (Street or P.O. Box, City, State, Zip Code)
Place of Birth
(City/State or Country)
Phone Number
Work e-Mail
Personal E-Mail
Current Military Assignment or Place of Employment; Address
Phone Number
Father’s Name
(Last)
(First)
(MI)
Father Deceased
P
A
Father’s Date of Birth (Month/Day/Year)
Place of Birth
(City/State or Country)
R
E
N
Mother’s Name (Last)
(First)
(MI)
Mother Deceased
T
S
Mother’s Date of Birth (Month/Day/Year)
Place of Birth
(City/State or Country)
Parent’s Current Mailing Address
Phone Number
M S
Wife’s Maiden Name (or Husband’s Name)
Married
A T
R A
Single
If USMA Graduate, Class
I
T
Widow(er)
T U
Spouse’s Date/Place Birth
Date/Place of Marriage
Divorced
A S
L
If Spouse Deceased, List Date and Place of Death
Name(s) of Spouse(s) by Previous Marriage(s); if USMA Graduate, Class
If Deceased, List Date
Individuals who might assist in preparation of memorial Article
Name
Address
~Page 1 of 2~

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