The United States Navy Honorable Discharge Lapel Pin
INSTRUCTIONS:
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 or the veteran's DD-214 or NAVPERS 553, or other pre-arranged military document(s) to the 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.
(Your active-duty entry date appears on your Report of Military Service [DD-214, etc]):
Month/Day/Year discharged from uniformed military service (Example: 09/26/1984)
(Your active-duty discharge date appears on your Report of Military Service [DD-214, etc]) :
SERVICE NUMBER:
Enter the veteran's FIRST FOUR DIGITS ONLY(Do Not enter any alphabet letters. Numbers only.)
Enter the SECOND FOUR (or remaining) DIGITS ONLY
I have not moved. My current address info is on file from a previous application
Address:
City:
State:
ZipCode:
Phone (NO SPACES OR DASHES):
Your full and complete contact email address:
If you are sending a Check or Money Order please indicate:
I will mail a Check along with my application and documentation. The Library will receive my envelope within 10 days from today.
I will mail a Money Order along with my application and documentation. The Library will receive my envelope within 10 days from today.
CHARGE or DEBIT CARD applicants:
-- My current Card information is already on file from a previous Application
If your Card information is not on file, please Complete the following...
This section for Charge Card and Debit Card applicants. If you are sending a Check or Money Order please skips this section:
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 Card Verification Number (CVV Code) (See below) American Express: 4 digits on front of card All other cards, 3 digits on back
After printing this form for mailing, please sign here:
TOTAL ADMIN PROCESSING/DELIVERY Choose one of the following...:
Certificate in Bond Enclosure $29.50 (shipping included)
Certificate in Bond Enclosure & Pin $39.50 (shipping included)
Certificate in Bond Enclosure & Wallet Card $35.77 (shipping included)
Certificate in Bond Enclosure & Pin & Wallet Card $45.50 (shipping included)
POCKET-SIZE, LAMINATED DD-214
No, I do not want the pocket-size DD-214.
$6.00 -- Yes, if a pocket-size, laminated DD-214 can be made, please include one.
ARCHIVE FILE-COPY FOR MY MANAGER
Would you like an archive (black&white) copy of the Certificate you are applying for to be mailed from the Records Chief directly to your Commanding Officer -or- to your Employer -or- to your School Administrator for inclusion into your permanent personnel file jacket? (Fee: $3.77) Available only when a published certificate is requested. Not available with emailed certificates.
No.
Yes, please mail an embossed, B&W copy of my Certificate to the following person and address:
Official's name
Official's Title
Official's Agency Name (name of unit, vessel, office, school, etc.)
Address
City, State, Zip
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 Awards and add $4.00 to my total
Yes, please include a Medal Will for a FEMALE heir of my Awards and add $4.00 to my total
Would you like to track your package 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
Ignore this final Question if you will EMAIL or have previously EMAILED a copy your DD-214...
Would you like your mailed DD-214 scanned by The War Library and integrated into your 201A Award Report that will be emailed to you when your requested item(s) are sent to you? The scanning fee is $3.00 (a one-time fee)
Yes, add a one-time $3.00 to my total to Scan and Integrate my DD-214 into my Award Report
No, I will accept my Award Report without my DD-214 appearing in the Report
Your Application Form is now complete. After clicking the button below to send this Form you will soon receive a confirmation email containing final instructions on which items, if any, are needed to fulfill your request. Your DD-214 can be mailed or emailed. Non-personalized items such as hardwear may be exchanged or returned within ten days of delivery.
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..
Please lower your mouse then wait a moment for your info to be logged.
Check Debit
American Express: 4 digits on front of card
All other cards, 3 digits on back