HEADS UP: 134th Assault Helicopter Company Brothers/Family Member


Please complete as many of the following items of information as are applicable, keeping in mind some fields are required. Revisit this form and resubmit it any time your information changes - there are fewer of us around every year and we don't want to lose track of anyone!! Information that you submit will not be released outside the 134th AHC family.


A cellular phone number is requested because experience has shown when individuals relocate they frequently retain the same cellular number; this gives us a shot at contacting you should you forget to send us your new information. Our goal is to keep you connected with 134th AHC brothers.


If you're not sure whether the data we have is current, submit the information anyway. Better to have duplicating data than none!


First name:

 *

Last name:

 *
Nickname (if any):
Wife's name:
Street address/PO Box: *
City: *
State:
Zipcode: *
Home phone number:  *
Cell phone number: (if you use your cellular for your home phone, please
enter your cellular number as BOTH your home and cell number)
Email address: *
Dates in the 134th: From: * Until: *
Other (platoon, job, etc.):
 
* denotes required field.

Last modified: Sunday March 12th, 2023