Questions About This Form? Use Email

1. Complete this form in full. ( Click here to email amerwar@amervets.com if you have any technical problems sending this Application Form after you have completed it )

2. Click the button at the bottom of this completed form to email it to The War Library, along with a copy of your DD-214, WD 53-55, or you can Print and mail this form and the required documents to the Library's mailing address below.

Do Not Hilite, Underline, Circle, Colorize
Or Mark In Any Way The DD-214
Or Other Military Document Photocopy
You Will Be Sending.

    Charge card or Debit card applicants: To expedite shipment of your Recognition you may email this form today. Your Recognition will be prepared and awaiting the arrival of your DD-214 or other, pre-arranged military document(s).

    Type of Award:

    Recipient's LAST Name:
    FIRST Name:
    MIDDLE name:
    Title (Must appear on military documentation):Jr Sr II III IV

    Is this recipient currently living, deceased or KIA:
      LIVING
      DECEASED
      KILLED IN ACTION

    I have not moved. My current address info is on file from a previous application

    Street Address:

    City:
    State:
    ZipCode:
    Phone:

    Partial SSN:

  • Enter the recipient's FIRST FOUR DIGITS ONLY ) 
  • Enter the SECOND FOUR DIGITS ONLY  

    • Your full and complete email address:

    Military Base Where Awarded:

    Date of Award:

    If you are sending a Check or Money Order please indicate:

    • I will mail a Check along with my application and documentation
    • I will mail a money order along with my application and documentation

    Charge or Debit Card applicants, please complete the following:

    Your Name as it appears on your charge or check debit card:

    Payment Method
      Check Debit
      Visa
      MasterCard
      American Express
      Discover
      Diners Club
      Carte Blanche

    Card number:
    Expiration Date

    After printing this form for mailing, please sign here:

    International shipping cost (U.S. veteran living outside the United States, please add the shipping cost you were quoted...

    TOTAL ADMIN PROCESSING/DELIVERY:

    I want to purchase the Full Color...

  • PDF emailed (full color, printable) ($7.50) (No shipping fee)
  • Document shipped ($24.50)...
       Document only with wallet card ($30.50)
  • Document shipped in Bond Enclosure ($29.50)... with wallet card ($35.50)
  • I do not want the Display Recognition. I am requesting the hardware items listed below (medal, badge, ribbon or patch) if they are available for this award. (Shipping cost applies to non-certificate requests.)

    Would you like to receive the Official, full size Commander's Award for Civilian Service replacement medal?

  • Yes, please include the official medal and add an additional $12.50 to my total.
  • No, I already have the hardware.

    • Would you like to receive the Official, full size Commander's Award for Public Service replacement medal?

  • Yes, please include the official medal and add an additional $12.50 to my total.
  • No, I already have the hardware.

    • Would you like to receive the Official, full size Achievement Medal for Civilian Service replacement medal?

  • Yes, please include the official medal and add an additional $18.50 to my total.
  • No, I already have the hardware.

    • Would you like to receive the Official, full size Meritorious Civilian Service replacement medal?

  • Yes, please include the official medal and add an additional $12.50 to my total.
  • No, I already have the hardware.

    • Would you like a published copy of My Military Medal Last Will And Testament?

  • Yes, please include a Medal Will for a male heir of my medals and add $4.00 to my total
  • Yes, please include a Medal Will for a female heir of my medals and add $4.00 to my total
  • No, I will obtain the free jpg copy

    • Would you like to track your package using the internet through the United States Post Office after it has been shipped (for twenty [.20] cents extra)?

  • Yes, add 20 cents to my total
  • No, I don't want to track my package

    • Click Here if you are a Prior Applicant who's DD-214 is on file
    New Applicants Click Here

    Your Application Form is now complete. Print, Sign and Mail this completed form to the address below along with the required military-issued Report of Separation or other (pre-approved) document(s). You may (OPTIONAL) email this form for faster processing. However, you must still mail or fax a copy of your military document(s).

Records Chief (REC-AMW)
The American War Library
817 East Via Carmelitos
Virginia Building 319
Long Beach CA 90805-7549
Phone: 1-562-422-4100 (Pacific Time Zone)

LINK: Policy Statements On Display Recognitions and Hardwear
Name-personalized items that are produced uniquely for a recipient may not be exchanged or returned. However, although typographical errors are very rare, there is no time limit on requesting corrections to errors.

Print a copy for yourself before clicking the bar below..