58th Membership Roster
First Name:
Last Name:
Name of person if other than
Veteran completing this form:
Current address/street:
City:
State: Zip:
E-Mail (optional):
Family Information (start with your Parents and include the names and relationships that you feel are appropriate):
Hometown when you entered the Service:
Service Number:
Date you entered the Service:
Service Schools attended:
Month/Year
Month/Year
Month/Year
Military Specialty Earned/Assigned:

1)

  2)
Military Rank Upon Discharge:
Bomb Group: 40th: 444th: 462nd : 468th: Other:
Squadron: 25th: 676th: 768th: 792nd: Other:
  44th: 677th: 769th: 793rd: Other:
  45th: 678th: 770th: 794th: Other:
  395th: 679th: 761st: 795th: Other:
Location of Unit when assigned:
Date:
Awards/Decorations received:
Missions Flown (if applicable):
Hump Missions Flown (if applicable):
Targets:
Ground Crew: Yes No
Flight Crew: Yes No
If "Yes" to either of the above:
Aircraft Serial Number/s:
Aircraft Name/s:
Were you a POW?: Yes No
Where?:
Were you interned?: Yes No
Where?:
Date transferred from the
58th Bomb Wing:
Date Discharged:
Post-World war II Military Service:
Post-World war II Civilian Occupation/s:
Your thoughts about what your service in the 58th Bomb Wing during World War II means to you:
Further Comments :
Image:
Image Caption: