Picture form

Please fill out the form below to add your info to the A/5/12 Database

First Name

Middle Initial

Last Name

Nickname

Platoon

Rank

Where did you live before you joined Army

Home Phone

Street Address

City, State, Zip

Date you arrived in Vietnam

Date you departed Vietnam

Your Email Address

If someone from A/5/12 asks for your current info? Please select one of the following:

Do you plan on attending next years reunion?YesNo

Comments

First Name
Middle Initial
Last Name
Nickname
Platoon
Rank
Where did you live before you joined Army
Home Phone
Street Address
City, State, Zip
Date you arrived in Vietnam
Date you departed Vietnam
Your Email Address
If someone from A/5/12 asks for your current info? Please select one of the following:

Webmaster: Gary Pierce Copyright © 1999 [Gary Pierce]. All rights reserved. Revised: June 08, 2002

Webmaster: Gary Pierce
Copyright © 1999 [Gary Pierce]. All rights reserved.
Revised: June 08, 2002