Is this veteran currently living, deceased or KIA:
KILLED IN ACTION
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
Date School Attendance began:
Date of Graduation or completion:
If you are sending a Check or 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 ($25.60)... Document only with wallet card ($31.60)
Document shipped in Bond Enclosure ($30.60)... Document in Bond Enclosure with wallet card ($36.60) (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 twenty [.20] cents extra)?
Yes, add 20 cents to my total No, I don't want to track my package
Ignore this final Question if you will EMAIL or have previously EMAILED a copy your DD-214...Would you like your mailed DD-214 scanned by The War Library and integrated into your 201A Award Report that will be emailed to you when your requested item(s) are sent to you? The scanning fee is $3.00 (a one-time fee)
Yes, add a one-time $3.00 to my total to Scan and Integrate my DD-214 into my Award Report No, I will accept my Award Report without my DD-214 appearing in the Report
Your Application Form is now complete. Print, Sign and Mail this completed form to the address below along with the required military-issued Report of Separation or other (pre-approved) document(s). You may (OPTIONAL) email this form for faster processing. However, you must still mail or email a copy of your military document(s).