Form to record personal data from brigadistas from Brigada 2506 BOP

Personal Data Sheet

"Information regarding the Veterans of Bay of Pigs Invasion is being voluntarily disclosed for the purpose of preserving records and contributing to the historical narrative, both for the museum and future researchers"
Please sign and acknowledge to submit this form even if all fields are not completed.
BRIGADE MEMBER FULL NAME

First NameLast Name
FULL NAME OF PERSON THAT FILLS OUT THIS FORM

First NameLast Name
BRIGADE #
CIA NUMBER
BRIGADE MEMBER'S MOST RECENT CIVIL STATUS
NAME OF SPOUSE OR PARTNER, IF APPLICABLE
NAME AND CONTACT INFORMATION OF CHILDREN AND/OR OTHER RELATIVES
IS BRIGADE MEMBER DECEASED?
IF DECEASED, ENTER DATE OF DEATH

MonthDayYear
Date
CAUSE OF DEATH
COMMENTS
E-MAIL
example@example.com
PHONE NUMBER
Format: (000) 000-0000.
CURRENT ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
HIGHEST LEVEL OF EDUCATION ACHIEVED
GRADUATION DATE

MonthDayYear
Date
WORK STATUS
IF RETIRED, SINCE

MonthDayYear
Date
COMMENTS
PERSONAL DATA

Complete personal data as it pertains prior to joining the Brigade
DATE OF BIRTH

MonthDayYear
MOTHER'S FULL NAME
FATHER'S FULL NAME
ADDRESS IN CUBA

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
HIGHEST GRADE OR LEVEL OF SCHOOL ACHIEVED AT TIME OF ENLISTMENT
DATE

MonthDayYear
Date
OCCUPATION OR STUDENT STATUS BEFORE ENLISTMENT
TITLE
ADDITIONAL INFORMATION OR COMMENTS
RECORD DURING ENLISTMENT

Fill out to record personal data info during the enlistment
DATE OF ENLISTMENT

MonthDayYear
Date
GROUP BELONGED TO AT TIME OF ENLISTMENT
ANY OTHER GROUP
COMMENTS
SOCIAL AND POLITICAL ACTIVISM
SELECT UNIT
SELECT BATALLION
SQUAD
SPECIALTY
LANDING SITE
COMMENTS
RECORD AFTER THE INVASION
COMMENTS RELATED TO MOMENT OF CAPTURE
SENTENCE
RANSOM
SELECT LOCATION WHERE DETAINED/IMPRISONED
IF OTHER SPECIFY WHERE DETAINED
TIME IMPRISONED
RELEASE DATE

MonthDayYear
Date
COMMENTS
SUPPORTING DOCUMENTS UPLOAD (i.e. photos, legal records)

Cancelof
DISCLOSURE FORM STATEMENT
Signature
Should be Empty:

Personal Data Sheet

PERSONAL DATA

RECORD DURING ENLISTMENT

RECORD AFTER THE INVASION