Phone: 1-562-422-4100 (Pacific Time Zone)
Email Questions

Iraq Joint Commitment Medal
Display Recognition Application Form

(The Medal and Ribbon are not available at this time.)

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 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 Be Sending.

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


Is this veteran currently living, deceased or KIA:
  LIVING
  DECEASED
  KILLED IN ACTION


Service Branch:

Military Rank Title (Please Do Not Abbreviate):

Military Paygrade
Enlisted
Warrant
Officer


I have not moved. My current address info is on file from a previous application

Address:
City:
State:
ZipCode:
Phone:


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  

  • Date arrived in-country Iraq:

    Date departed Iraq:


    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
      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 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 to track your package using the internet 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

    You will shortly receive a confirmation email/receipt acknowledging your application arrived, or should we have a question or require more information. Please ensure that you have entered a correct email address.

    To email this form click the button below. To mail this form address your envelope to:

    Records Chief (REC-AMW)
    The American War Library
    817 East Via Carmelitos
    Virginia Building 319Long Beach CA 90805-7549

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