Vital Statistics Sheet - Association Of Graduates Page 2
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2C
H
Full Name
Date & Place of Birth
Date & Place of Death
I
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L
____________________________________________________________________________________
D
____________________________________________________________________________________
R
____________________________________________________________________________________
E
N
____________________________________________________________________________________
Full Name
Relationship
U
____________________________________________________________________________________
S
M
____________________________________________________________________________________
A
____________________________________________________________________________________
____________________________________________________________________________________
K
____________________________________________________________________________________
i
____________________________________________________________________________________
n
Military Assignments/Civil Employment (cite firms) Awards
Dates
Unit
Location
Duty
Decoration/Awards
____________________________________________________________________________________________________________
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Now on active duty
Rank:______
MIL/CIV
Civilian Title, if any:
Retired from military Rank:______
Date:______
STATUS
__________________
Resigned/Separated
Rank:______
Date:______
NG/USAR
Rank:_____
Military/Civil Education
School
Years
Deg/Compl
School
Dates
Deg/Compl
____________________________________________________________________________________________________________
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Photographs (Protect for Mailing; Identify on Back)
Photo Enclosed
Photo to be Forwarded by e-mail to
____________________________________________________________________________________________________________
Miscellaneous information you might wish to include in your permanent file (use additional sheets if necessary).
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Date:
Signature:
Please either fax (845)446-1685, ATTN: Marilee Meyer, Archivist, or mail the information to:
Association of Graduates, ATTN: Marilee Meyer, Archivist, 698 Mills Road, West Point, NY 10996
~Page 2 of 2~
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