Registration ( Ghi Danh)

SECTION A -- Personal Information (Ly Lich Ca Nhan)

Please complete all these questions.(Xin dien vao cac cau hoi duoi day)

1. What is your mailing address? Dia Chi?

   Last Name (Ho)    
   First Name ten)  
   Middle Name (Ten Lot)  
   Street (Duong)        
   City (Thanh Pho)      
   State(Tieu Bang)       Zip Code  + Four 
           

2. What are your other Points of Contact (Cac phuong tien lien lac khac)

   E-mail     
   Area Code   Phone Number  

3. Did you retire from the Army? Ban duoc giai ngu tu Quan Doi truoc nam 1975?Yes No 

4. What was your highest/retired rank? Cap Bac sau cung khi Giai Ngu 

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SECTION B -- Liet Ke nhiem vu da dam trach

Please be as specific as you can, in providing the details of your Special Forces Assignments. (Xin liet ke cac chuc vu ban da dam trach

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SECTION C -- Other information (Muc Linh tinh)

1. Please check the statements for which your answer is "Yes." (Xin danh dau vao day ho so gui di voi tinh cach)

   Ghi Danh
   Sua doi ten, ngay thang trong ho so.
   

2. Please enter any additional comments. Xin viet them nhung thac mac va cau hoi cua ban vao khung duoi day
   
   
   
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FORM SUBMISSION

Thank you for taking the time to answer the questions in this form. Please review your input for accuracy. (Cam on ban da dien cac cau hoi, xin kiem soat lai cac tiet muc cho chinh xac truoc khi gui di)

This information will be compared to and posted to the database.

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