SECOND FOUR (or remaining) DIGITS ONLY
If you are sending a Check or Money Order please indicate:
Charge or Debit Card applicants, please complete the following:
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 ($7.50) (No shipping fee)
Document shipped ($23.90)... Document only with wallet card ($29.90)
Document shipped in Bond Enclosure ($28.90)... Document in Bond Enclosure with wallet card ($34.90) (The shipping totals above include the USPS - Priority Mail shipping fee)
Which type ould you like to receive the official, Lapel replacement rank insignia?
No. I already have the patches
Private E2, ($5.50 each)
Private First Class, ($5.50 each)
Specialist (Fourth Class), ($5.50 each)
Corporal, (5.50 each)
Sergeant, ($5.50 each)
Staff Sergeant, ($5.50 each)
Sergeant First Class, ($5.50 each)
Master Sergeant, ($7.50 each)
First Sergeant, ($7.50 each)
Sergeant Major, ($7.50 each)
Command Sergeant Major, ($7.50 each)
Which type would you like?
Polished Brass collar insignia | OR Two Polished Brass collar insignias
Combat Subdued collar insignia | OR Two Combat collar insignias
One Brass, One Combat Subdued collar insignia
Shoulder (Gold) Stripe | OR Two Shoulder (Gold) Stripes
Black Stripe (may be discontinued) | OR Two Black Stripes
Combat Subdued Shoulder Patch
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 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 email a copy of your military document(s).