Army Weapons and Special Badge Qualification
Replacement Recognition 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, or you can Print and mail this form along with a copy of the DD-214, WD AGO 53-55, NAVPERS 553, NGB or other pre-arranged documents to the Library's mailing 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.

Charge card or Debit card applicants: To expedite shipment of your Recognition Replacement you may email this form today. Your Recognition Replacement will be prepared and awaiting the arrival of your military document(s) and a printed copy of this application.

Qualification Status:

Certificate and/or hardwear type (USPS Shipping fee is included):

Select which Certificate(s) you want:

  • I do not want a certificate.
  •    AA Artillery certificate Select Unselect
  •    Aerial Bomber certificate Select Unselect
  •    Aeroweapons certificate Select Unselect
  •    Automatic Rifle certificate Select Unselect
  •    Bayonet certificate Select Unselect
  •    Carbine certificate Select Unselect
  •    Coastal Artillery certificate Select Unselect
  •    Field Artillery certificate Select Unselect
  •    Flamethrower certificate Select Unselect
  •    Grenade certificate Select Unselect
  •    Howitzer certificate Select Unselect
  •    Machinegun M240 certificate Select Unselect
  •    Machinegun M249 certificate Select Unselect
  •    Machinegun MG-M4A1 certificate Select Unselect
  •    Machinegun certificate Select Unselect
  •    Mines certificate Select Unselect
  •    Missile certificate Select Unselect
  •    Mortar certificate Select Unselect
  •    Pistol certificate Select Unselect
  •    Recoiless Rifle certificate Select Unselect
  •    Rifle M-14 certificate Select Unselect
  •    Rifle M-16 certificate Select Unselect
  •    Rocket Launcher certificate Select Unselect
  •    Submachinegun certificate Select Unselect
  •    Sword certificate Select Unselect
  •    Tank Weapons certificate Select Unselect
  •    TD 3-inch certificate Select Unselect
  •    TD 37-mm certificate Select Unselect
  •    TD 57-mm certificate Select Unselect
  •    TD 75-mm certificate Select Unselect
  •    M-110 Sniper Rifle certificate Select Unselect
  •    M-2010 Sniper Rifle certificate Select Unselect
  •    60-mm Mortar certificate Select Unselect
  •    81-mm Mortar certificate Select Unselect
  • Other Weapon not listed above:

    • Name of Military Base where qualified:
    Date qualified:

    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

    Rank Title (Please Do Not Abbreviate):

    Paygrade
    Enlisted
    Warrant
    Officer

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

    Address:
    City:
    State:
    ZipCode:
    Phone (NO SPACES OR DASHES):

    Your full and complete contact email address:

    SERVICE NUMBER:
    (Do Not enter any alphabet letters. Numbers only.)
    ★ Enter the veteran's 1st FOUR DIGITS ONLY  ☛ 
    ★ Enter the 2nd FOUR (or remaining) DIGITS ONLY   ☛ 

    If you are sending a Check please indicate:

    • I will mail a Check 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...

      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 receive the Official, full size Badge?

    • No, I already have the hardwear.

      • Badge Type:

    • Yes, please include the official badge I selected above and add an additional $8.50 to my total.

      • Would you like to receive the official Rocker ($4.50 additional) that hangs under the Badge?

      AA Artillery Rocker $4.50    Select Unselect
      Army PUC Rocker $4.50    Select Unselect
      Auto Rifle Rocker $4.50    Select Unselect
      Bayonet Rocker $4.50    Select Unselect
      Carbine Rocker $4.50    Select Unselect
      Driver A Rocker $4.50    Select Unselect
      Driver M Rocker $4.50    Select Unselect
      Driver T Rocker $4.50    Select Unselect
      Driver W Rocker $4.50    Select Unselect
      Driver Rocker $4.50    Select Unselect
      Expert Shooting Rocker $4.50    Select Unselect
      Field Artillery Rocker $4.50    Select Unselect
      Flame Thrower Rocker $4.50    Select Unselect
      Grenade Rocker $4.50    Select Unselect
      Machine Gun Rocker $4.50    Select Unselect
      Marksman Rocker $4.50    Select Unselect
      Mechanic Rocker $4.50    Select Unselect
      Missile Rocker $4.50    Select Unselect
      Mortar Rocker $4.50    Select Unselect
      Operator S Rocker $4.50    Select Unselect
      Pistol Rocker $4.50    Select Unselect
      Recoiless rifle Rocker $4.50    Select Unselect
      Rifle Rocker $4.50    Select Unselect
      Rocket Launcher Rocker $4.50    Select Unselect
      Sharpshooter Rocker $4.50    Select Unselect
      Submachinegun Rocker $4.50    Select Unselect

      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. 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.

      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)

    LINK: Policy Statements On Display Recognitions and Hardwear
    Name-personalized items that are produced uniquely for a recipient may not be exchanged or returned. However, although typographical errors are very rare, there is no time limit on requesting corrections to errors.

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