Ia Drang Scholarship Registration Form

This application is for registration of descendants of designated units that fought in the Ia Drang valley of Vietnam during the period, 3-19 November, 1965.
Name of Soldier*
Unit and Dates When Assigned to the Division*
Soldier Certification*
- I certify that I was a soldier of the 1st Cavalry Division, a USAF Forward Air comptroller, an A-lE pilot or a War Correspondent who participated in the battle(s) of the Ia Drang valley during the period 3-19 November, 1965. The persons named below are my children and/or grandchildren. Birth Certificates of all children and grandchildren documenting that status and documentation of my participation in the Ia Drang battle(s) are attached. Males must provide proof of registration with the Selective Service prior to receiving a scholarship grant.
Name(s), Address, Birth Certificate of Child(ren) or Grandchild(ren)
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student SSN*

Required by IRS.
Student ID if applicable
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student SSN*

Required by IRS.
Student ID if applicable
Birth Certificates Attachment Upload(s)
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 512 MB, Max. files: 4.
Service Documentation
Service Documentation Attachment Upload(s)
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 512 MB, Max. files: 12.
Please provide documentation of your assignment to the 1st Cavalry Division.
I understand that I will receive confirmation of registration for each eligible child/grandchild and that I must keep the Foundation informed of each child/grandchild's current address, that each registered child/grandchild must make application for a scholarship grant upon acceptance at a recognized institution of higher education. Application forms are available from the Foundation.
Applicant Digital Signature
Applicant's Email*
Applicant's Phone*
Applicant's Address*
Street Address Address Line 2 City State ZIP Code
Applicant Comments or Questions
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Ia Drang Scholarship Registration Form