Battle Participation
Replacement Recognition and Ribbon Application Form

INSTRUCTIONS:

    1. Complete this form in full.
    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, DD-215, WD AGO 53-55 and other, if applicable, 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 Are Sending.

    Charge card or Debit card applicants: To expedite shipment of your Replacement Recognition you may email this form today. Your Replacement Recognition will be prepared and awaiting the arrival of your DD-214, DD-215, WD AGO 53-55 and other, if applicable, military document(s).


    2. 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

    3. Service Branch:

    4. Rank Title (Please Do Not Abbreviate):

    6. Street Address:

    City:
    State:
    ZipCode:
    Phone:

    7. Full and complete contact email address:

    Please enter the FIRST EIGHT DIGITS ONLY of the Recipient's Service Number:


    Complete at least ONE Situation Report...

    Situation #1:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #2:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #3:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #4:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #5:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #6:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:

    Situation #7:

    Location of combat situation:
    Date of situation:
    Name of unit or vessel:


    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:

    -- 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

    Would you (also) like to receive the Battle Participation Ribbon?

    • Yes, please include the Battle Participation Ribbon and add an additional $8.00 to my Certificate total
    • No, I already have the hardwear

  • Would you like the full-color Wallet Size Certificate along with one of the above full-size color Certificate ($3.50) Yes No

    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: $3.50)

  • 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?

  • No, I will obtain the free jpg copy
  • Yes, please include a PUBLISHED VERSION of the Medal Will for a MALE heir of my Awards and add $4.00 to my total
  • Yes, please include an EMAILED VERSION Medal Will for a MALE heir of my Awards and add $2.50 to my total
  • Yes, please include a PUBLISHED VERSION of the Medal Will for a FEMALE heir of my Awards and add $4.00 to my total
  • Yes, please include an EMAILED VERSION Medal Will for a FEMALE heir of my Awards and add $2.50 to my total

  • Would you like to track your package 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. 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

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