Appendix D

EMERGENCY INFORMATION FORM

Soldiers Name:  _____________________________________________________________ Soldier's Social Security Number:  _______________________________________________

Stateside Information

Unit:  _______________________________ Company:  _____________________________ Company Commander:  ______________________________  Phone number:  ____________             Platoon Leader:  ___________________________________   Phone number:  ____________                     1st Sgt:  __________________________________________  Phone number:  ____________                    Platoon Sgt:  ______________________________________   Phone number:  ____________                      Family Support Group Contact Person:  __________________  Phone number:  ____________                  Chaplain:  ________________________________________   Phone number:  ____________

Deployment Information

Location:  ______________________________  Unit:  ______________________________ E-mail Address:  ________________________  Phone #:  ____________________________ Mailing Address:  ____________________________________________________________ __________________________________________________________________________ Company Commander:  __________________  1st Sgt:  ______________________________ Officer in Charge:  ______________________   NCO in Charge:  _______________________ Team Leader:  _________________________  Chaplain:  _____________________________