Phone/Fax: 1-310-532-0634

    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 Mark Your DD-214
or Other Military Document!!!

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:
FIRST Name:
MIDDLE name:
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:

Recipient's Military Occupational Number:

Recipient's Military Occupation Title:

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
    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:

  • U.S. delivery - Bond Enclosure $25.70 Navy Regal Black
  • U.S. delivery - EnDurable Frame, Acrylic Brown, $27.70
  • U.S. delivery - EnDurable Frame, Acrylic Black, $27.70
  • U.S. delivery - Gold Color Frame, $32.70 Gold
  • U.S. delivery - Packaged to be framed by me $25.70 Unframed
  • I do not want the Display Recognition. I am requesting the hardware items (medal, badge, ribbon or patch) if they are available for this award, below. (Additional shipping cost applies to non-certificate requests.)

    • 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 [.70] cents extra)?

    • Yes, add 70 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
    Building Two, 16907 Brighton Avenue
    Gardena CA 90247-5420
    Phone/Fax: 1 310 532 0634