Phone/Fax: 1-310-532-0634

    Outstanding Volunteer Service Medal
    Replacement Recognition Application Form

    INSTRUCTIONS:

1. Complete this form in full.
2. Print and mail or fax this completed form, along with a copy of your or the veteran's DA-638, or CG 1650, or NAV 1650, or AF 642 to the address below.

Charge card or Debit card applicants: To expedite shipment of your Replacement Recognition you may email this form today. Your Replacement Recognition will be prepared and awaiting the arrival of your DA-638, or CG 1650, or NAV 1650, or AF 642.

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

Rank Title (Please Do Not Abbreviate):

Paygrade
Enlisted
Warrant
Officer

Street Address:

City:
State:
ZipCode:
Phone:

Full and complete contact email address:

Recipient's Service 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

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.

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

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

    Card number:
    Expiration Date

    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:

  • .PDF Emailed - $9.50 Black & White (No Color)
  • U.S. delivery - $21.10 Document Only
  • U.S. delivery - Bond Enclosure $25.60
    Navy
    Regal
    Black
    Military Standard Issue
  • U.S. delivery - EnDurable Frame, Acrylic Brown, $27.60
  • U.S. delivery - EnDurable Frame, Acrylic Black, $27.60
  • U.S. delivery - Gold Color Frame, $32.60 Gold
  • I do not want the Display Recognition. I am requesting the hardware items (medal, badge, ribbon or patch) if they are available for this award, below. (Additional shipping cost applies to non-certificate requests.)

    • Would you like to receive the Official, full size Outstanding Volunteer Service medal and/or ribbon?

  • Yes, please include the official medal and add an additional $11.50 to my total

  • Yes, please include the official ribbon and add an additional $4.00 to my total

  • Yes, please include the official medal and the ribbon, and add an additional $15.50 to my total

  • No, I already have the hardware

    • Would you like to receive the Miniature Outstanding Volunteer Service medal?

  • Yes, please include the Miniature medal and add an additional $8.00 to my total.

  • No, I already have the hardware.

    • 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 sixty-five [.65] cents extra)?

      • Yes, add 65 cents to my total

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

      Click Here if you are a Prior Applicant who's DD-214 is on file
      New Applicants Click Here

      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 fax a copy of your military document(s).

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