Telephone and Fax: 1-310-532-0634

USMC Enlisted Promotion
Replacement Recognition Application Form

INSTRUCTIONS:

    1. Complete this form in full.
    2. Print and mail this completed form, along with a copy of your or the veteran's DD-214, NAVPERS, NAVMC or other pre-arranged military document(s) to the address at the bottom of this secure form.

    Do Not Hilite, Underline, Circle, Colorize
    Or Mark In Any Way The DD-214
    Or Other Military Document Photocopy
    You Will Mail.

    Recipient's LAST Name:
    FIRST Name:
    MIDDLE name:
    Title (Must appear on DD-214):Jr Sr II III IV

    Please Select Badge Type:

    Private First Class
    Lance Corporal
    Corporal
    Sergeant (Current) | Sergeant (Pre-1959
    Staff Sergeant (Current) | Staff Sergeant (Pre-1959)
    Gunnery Sergeant
    Master Sergeant
    First Sergeant
    Master Gunnery Sergeant
    Sergeant Major
    Sergeant Major of the Corps

    Year Promoted:

    Street Address:

    City:
    State:
    ZipCode:
    Phone:

    Full and complete contact email address:

    Recipient's Service/Serial Number:

    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

      • (Make payable to "Records Chief")

    Charge or Debit Card applicants, please complete the following:

    Please choose between ASAP or Monthly shipping...

  • I want the items on this Application Form (and other Forms I am submitting today) to be shipped As Soon As Possible.
  • I want the items on this Application Form (and other Forms I am submitting today) to be shipped in monthly groups of...

      Ship 1 of my Application Forms per month
      Ship 2 of my Application Forms per month
      Ship 3 of my Application Forms per month
      Ship 4 of my Application Forms per month

    Bill my charge/debit card and send me an email receipt between the 1st and 5th day of each month for each shipment. Please note that I am using a credit/debit card that will not expire before all of my monthly shipments have been sent to me.

    (Charge and Debit Card applicants can FAX (1-310-532-0634) this page along with the Report of Separation for FASTER processing and delivery.)

    Your Name as it appears on your charge or check debit card:

    Payment Method
      Check Debit
      Visa
      MasterCard
      American Express
      Diners Club
      Discover
      Carte Blanche

    Card number: _______________________________________
    Enter your Card Number after printing this form

    Card Expiration Date ________________
    Enter your Exp Date after printing this form

    After printing this form for mailing or faxing, 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 would like the following Display Recognition...
  • .PDF Emailed - $9.50 Black & White (No Color)
  • U.S. delivery - $21.20 Full Color Document Only
  • U.S. delivery - $25.70 Full Color Document in Bond Enclosure
  • I want ALL or SOME of my Certificates (minimum 20) in pdf format that I can print continuously, shipped to me on a CD rom that I can make copies of. (Library Note: See below for details)
  • I do not want the Display Recognition. I am requesting the hardware items listed below (medal, badge, ribbon or patch) if they are available for this award. (Shipping cost applies to non-certificate requests.)
  • Would you like the full-color Wallet Size Certificate along with one of the above full-size color Certificates ($3.50) Yes No
    I want Certificates in pdf format on a CD rom...

  • I want ALL of my Certificates in full color; $10.00 per Certificate
  • I want SOME of my Certificates (minimum 20) in full color; $10.00 per Certificate; I will be emailing a list of the 20 or more Certificates I want
  • I want ALL of my Certificates in Black&White; $8.00 per Certificate
  • I want SOME of my Certificates (minimum 20) in Black&White; $8.00 per Certificate; I will be emailing a list of the 20 or more Certificates I want
  • No CDrom

    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 to obtain the Official insigina?

    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 through the United States Post Office after it has been shipped (for seventy-five [.75] cents extra)?

  • Yes, add USPS's 45 cent tracking fee to my total

  • No, I don't want to track my package

    • SENDING INSTRUCTIONS

    Please do the following, in order:

    1. Print this Form now.

    2. If using your charge/debit card, enter the card number and the card's expiration date. Sign the form.

    3. After completing the form mail it, along with a photocopy of your DD-214 to the address below (for faster processing and delivery, charge/debit applicants may FAX this application and their DD-214). (PRIOR APPLICANTS: If you have previously mailed your DD-214 to The War Library you do not need to mail it again. Simply click the SEND button below.)

    4. Click the SEND button below to notify The War Library that your DD-214 will be arriving by fax or within a few days by mail.

Click Here if you are a Prior Applicant
New Applicants Click Here

MAILING ADDRESS
Records Chief (REC-AMW)
The American War Library
Building Two, 16907 Brighton Avenue
Gardena CA 90247-5420
Phone/Fax: 1 310 532 0634