Rank Title (Please Do Not Abbreviate):
I have not moved. My current address info is on file from a previous application
Phone ( NO SPACES OR DASHES):
Full and complete contact email address:
SERVICE NUMBER: Enter the veteran's FIRST FOUR DIGITS ONLY (Do Not enter any alphabet letters. Numbers only.)
SECOND FOUR (or remaining) DIGITS ONLY
If you are sending a check or USPS money order please indicate:
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...
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 ($22.45)...
with wallet card ($28.95)
Document shipped in Bond Enclosure ($27.45)... with wallet card ($33.45) (The shipping totals above include the USPS - Priority Mail shipping fee)
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 Agency Name (name of unit, vessel, office, school, etc.)
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 seventy-five [.75] cents extra)?
Your Application Form is now complete. After clicking the 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. (Non-personalized items such as hardwear may be exchanged or returned within ten days of delivery. Name-Personalized items such as Certificates that are produced uniquely for a recipient may not be exchanged or returned.)