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Questions About This Form? Use Email


Laminated
Unit, Base, Rank, Logo, Seal, Operation and Other Patches for Shadowbox Display
These laminated patches are not designed for wear on a military uniform

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. Print then email the completed form by clicking the button, below... or mail the completed form to the address below.

FULL Name of the unit, logo, base, seal, rank or operation (Please do not abbreviate):

UNIT MEMBER'S LAST Name (as it appears on the Report of Separation):
FIRST Name:

MIDDLE name:

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

Street Address:

City:
State:
ZipCode:
Phone (NO SPACES OR DASHES):

Full and complete contact email address:

Phone (NO SPACES OR DASHES):

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  

    • TOTAL PATCH AND USPS SHIPPING FEE:

  • Patch: $8.75
  • USPS Shipping: $9.90 (NOTE: There is no USPS shipping fee if the patch is shipped with the Certificate for this unit)

    • If you are sending a check or USPS money order please indicate:

    • I will mail a check along with my application and documentation
    • I will mail a USPS 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
    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:

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

    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

    • Your Application Form is now complete. After clicking the grey-bar 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).

    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)

  • I have read and understand the Certificate Return/Exchange Policy printed above.

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