Questions About This Form? Use Email


CLICK HERE for Your Military Medal Award Report


Military (Cloth) Patches Application Form

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. Print a copy of this form for yourself, then email the completed form by clicking the button, below...


All items are $10.00 each plus $9.90 USPS shipping.
(There is no patch or pin shipping fee when an item is shipped with a Certificate)


SELECT THE PATCH YOU WANT


VETERAN'S LAST Name:
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):


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

Street Address:

City:
State:
ZipCode:
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.) 
  • Enter the SECOND FOUR (or remaining) DIGITS ONLY  

  • If you are sending a check or USPS money order please indicate:

    • I will mail a check along with my application and documentation
    • I will mail a USPS money order along with my application and documentation

    Charge or Debit Card applicants, 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...


  • Yes, add 20 cents to my total
  • No, I don't want to track my package

  • Your Application Form is now complete. After clicking the grey-bar button below to send this Form you will soon receive a confirmation email

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

    Please lower your mouse then wait a moment for your info to be logged.

    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)

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