1. 1st -501st Infantry Soldier/Family Deployment Information Sheet
AUTHORITY: Title 10, USC, Section 3012. PRINCIPLE PURPOSES: To assist the Battalion Family Readiness Support Assistant (FRSA) and Company Family Readiness Groups (FRG) in
providing assistance to the Soldiers and Families of this Battalion. ROUTINE USES: (1) Compile Soldier & Family information into a Family Information Roster. (2) Compile names & phone
numbers into a telephone roster to be distributed to BN Senior Advisors, FRG Leaders, and Key Callers (3) Information sheets will be maintained in the FRSA proprietary/secured files and
made available to unit Commanders upon request. DISCLOSURE: Voluntary. EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION: Voluntary information is required to assist the
individual and his/her family members. Failure to provide the required information could result in a delay in providing assistance to the individual and/or family members.
1. Soldier's Information
Soldier's Name:
Company PLT SEC TEAM
Rank: Date of Birth (mm/dd): Last 4 Social Security Number:
Home Phone: Cell Phone: Work Phone:
Address:
E-mail Address:
Marital Status Single (proceed to section 5) Married Other Explain:
Are you dual military? Yes No If yes, provide unit he/she is in:
2. Spouse Contact Information
Name: Birthday (mm/dd) Anniversary (mm/dd)
Home Phone: Cell Phone: Work Phone:
E-mail Address:
Address: City/State/ZIP:
Mailing Address (if different): City/State/ZIP:
Does Spouse speak/understand English? Yes No If no, provide Spouse's primary language:
Interpreter Required? Yes No
Is Spouse/Soldier pregnant at this time? Yes No Due Date:
Do you have a family member enrolled in Exceptional Family Member Program (EFMP)? If yes, indicate special needs required:
3. Deployment Information
Spouse will NOT remain in Alaska during: OEF Deployment
If Spouse will not be in AK, provide address:
In the event Spouse requires emergency assistance (e.g. spouse is injured or hospitalized) while Soldier is training or deployed,
provide the name & phone number of someone in the LOCAL (Alaska) area who can assist him/her:
4. Child(ren) Information (If needed, use back of form)
Child's Name (First & Last) Date of Birth (mm/dd/yy) Address(if different from above)
Continued on reverse
For Official Use Only Rosters vFRG eAFMS Distro list
E-mail FRG Leader Welcome E-mail

2. 5. Parent Information
Name: Primary Phone:
E-mail Address:
Mailing Address: City/State/ZIP:
Name: Primary Phone:
E-mail Address:
Mailing Address: City/State/ZIP:
6. Pet Information (If needed, use back of form)
Pet Name Breed Vet Clinic
7. Virtual Family Readiness Group (vFRG) www.armyfrg.org
The vFRG web system is a secure website designed to assist commands in communicating with Soldiers, Civilian Employees, and Family Members, both
immediate and extended. List all family members /loved ones you wish to authorize access to the 425th BSTB vFRG website.
Name of Family Member/Loved One: E-mail Address:
7. Consent
The information on this form is for official use only and will not be furnished to any commercial enterprise, company, representative or agency outside the
Soldier's Signature: Date: