Foundation of the 1st Cavalry Division Association (Ia Drang)
Application for Registration for Scholarship Benefits

This application is for registration of descendants of the following named soldier, a veteran of service with the 1st Cavalry Division, for 1st Cavalry Division Association scholarship benefits:

NAME OF SOLDIER:  _________________________________________________________

UNIT AND DATES WHEN ASSIGNED TO THE DIV: _______________________________  

DATE OF DEATH : _____________________________

_____I certify that I was a soldier of the 1st Cavalry Division, a USAF Forward Air comptroller, an Al E pilot or a War Correspondent who participated in the battle(s) of the la Drang valley during the period 3-19 November, 1965. The persons named below are my children, grandchildren or great-grandchildren. Birth Certificates showing parentage, marriage certificates, documentation of my participation in the la Drang battle(s), and documentation of my membership in the 1st Cavalry Division Association are attached.  Male students musts provide proof of registration with the Selective Service prior to receiving a grant.  Great-grandchildren will be funded on a funds available basis.

NAME(S) AND ADDRESS OF CHILD(REN), GRANDCHILD(REN) OR GREAT-GRANDCHILD(REN): (Use a separate sheet for additional persons.)  PLEASE PRINT

1._________________________________________________________________________________  

2. _________________________________________________________________________________  

3. _________________________________________________________________________________  

4. _________________________________________________________________________________

5. _________________________________________________________________________________

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.  

SIGNED: ___________________________________________________________________

NAME: ____________________________________________________________________                        

ADDRESS: _____________________________________________________________________

CITY: ______________________________________ST: ______ZIP: _________________

PHONE: _________________________  

E-mail:  _________________________________________________________________________