Battle Participation
Replacement Recognition and Ribbon Application Form

INSTRUCTIONS:

    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. 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 (NO SPACES OR DASHES):

    7. Full and complete contact email address:


    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  

  • Complete at least ONE battle situation or campaign...

    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:

    Situation #8:

    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
      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...)


    TOTAL ADMIN PROCESSING/DELIVERY:

    I want to purchase the Full Color...

  • PDF emailed ($7.50) (No shipping fee)
  • Document shipped ($23.30)...
       Document only with wallet card ($29.30)
  • Document shipped in Bond Enclosure ($28.30)...
       Document in Bond Enclosure with wallet card ($34.30)
  • (The shipping totals above include the USPS - Priority Mail shipping fee)


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

  • Yes, please include the Battle Participation Ribbon and add an additional $10.50 to my Certificate total
  • No, I already have the hardwear

  • 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) Available only when a published certificate is requested. Not available with emailed certificates.

  • 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 Medal Will for a MALE heir of my Awards and add $4.00 to my total
  • Yes, please include a Medal Will for a FEMALE heir of my Awards and add $4.00 to my total

  • Would you like to track your package through the United States Post Office after it has been shipped (for forty-five [.45] cents extra)?

  • Yes, add 45 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)

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