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:
(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 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

  • I have read and understand the Certificate Return/Exchange Policy printed above.

    • 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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