Phone: 1-562-422-4100

    Army Professional
    Recognition Application Form

    INSTRUCTIONS:

1. Complete this form in full.
2. Print and mail or fax this completed form, along with a copy of your DD-214, WD 53-55, 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 Mail.

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).

Army Occupation:

Recipient's LAST Name (as it appears on the Report of Separation):
FIRST Name (as it appears on the Report of Separation):

MIDDLE name (as it appears on the Report of Separation):
Title (Must appear on military documentation):Jr Sr II III IV

Rank:

Street Address:

City:
State:
ZipCode:
Phone:

Your full and complete email address:

Recipient's Service Number:


If you are sending a check or USPS 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 USPS 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...

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

Payment Method
    Check Debit
    Visa
    MasterCard
    American Express
    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...

TOTAL ADMIN PROCESSING/DELIVERY:

  • .PDF Emailed - $7.50 Full Color
  • U.S. delivery - $22.35 Full Color Document Only
  • U.S. delivery - $27.35 Full Color Document in Bond Enclosure
  • I do not want the Display Recognition. I am requesting the hardwear 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 the full-color Wallet Size Certificate along with one of the above full-size color Certificates ($3.50) Yes No

    Would you like to receive the official, Branch 22K or Subdued Insignia (1 Pair)?

    22K Anodized Branch Insignia:

    Subdued Branch Insignia:


    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 seventy-five [.75] cents extra)?

    • Yes, add 75 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 Ste 319
    Long Beach CA 90805-7549
    Phone: 1-562-422-4100

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