Questions About This Form? Use Email

Vietnam Combat Campaign Service
Replacement Recognition Application Form


1. Complete this form in full. ( Click here to email 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, along with a copy of your or the veteran's DD-214 (or other pre-arranged military document(s)) to the 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.

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:

Service Branch:

Rank Title (Please Do Not Abbreviate):


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


Your full and complete contact email address:


  • Enter the veteran's FIRST FOUR DIGITS ONLY (Do Not enter any alphabet letters. Numbers only.) 
  • Enter the SECOND FOUR (or remaining) DIGITS ONLY  

  • Date Arrived In Vietnam
    Date Departed Vietnam

    I am selecting ONLY ONE campaign credit certificate
    I am selecting MORE THAN ONE campaign credit certificate

  • Nov 15 1961 to Mar 01 1965: Vietnam Initial Advisory Campaign
    Select Unselect
  • Mar 15 1962 to Mar 07 1965: Vietnam Advisory Campaign
    Select Unselect
  • Mar 08 1965 to Dec 24 1965: Vietnam Defense Campaign
    Select Unselect
  • Mar 02 1965 to Jan 30 1966: Vietnam Air Defensive Campaign
    Select Unselect
  • Dec 25 1965 to Jun 30 1966: Vietnam Counteroffensive
    Select Unselect
  • Jan 31 1966 to Jun 28 1966: Vietnam Air Counteroffensive
    Select Unselect
  • Jun 29 1966 to Mar 08 1967: Vietnam Air Offensive
    Select Unselect
  • Jul 01 1966 to May 31 1967: Vietnam Counteroffensive, Phase II
    Select Unselect
  • Mar 09 1967 to Mar 31 1968: Vietnam Air Offensive, Phase II
    Select Unselect
  • Jun 01 1967 to Jan 29 1968: Vietnam Counteroffensive, Phase III
    Select Unselect
  • Jan 22 1968 to Jul 07 1968: Vietnam Air/Ground Campaign
    Select Unselect
  • Jan 30 1968 to Apr 01 1968: Tet Counteroffensive
    Select Unselect
  • Apr 01 1968 to Oct 31 1968: Vietnam Air Offensive, Phase III
    Select Unselect
  • May 02 1968 to Jun 30 1968: Vietnam Counteroffensive, Phase IV
    Select Unselect
  • Jul 01 1968 to Nov 01 1968: Vietnam Counteroffensive, Phase V
    Select Unselect
  • Nov 01 1968 to Feb 22 1969: Vietnam Air Offensive, Phase IV
    Select Unselect
  • Nov 02 1968 to Feb 22 1969: Vietnam Counteroffensive, Phase VI
    Select Unselect
  • Feb 23 1969 to Jun 08 1969: Tet 1969 Counteroffensive
    Select Unselect
  • Jun 09 1969 to Oct 31 1969: Vietnam Summer Fall 1969
    Select Unselect
  • Nov 01 1969 to Apr 30 1970: Vietnam Winter Spring 1970
    Select Unselect
  • May 01 1970 to Jun 30 1970: Sanctuary Counteroffensive
    Select Unselect
  • Jul 01 1970 to Nov 30 1970: Southwest Monsoon
    Select Unselect
  • Jul 01 1970 to Jun 30 1971: Vietnam Counteroffensive, Phase VII
    Select Unselect
  • Dec 01 1970 to May 14 1971: Commando Hunt V
    Select Unselect
  • May 15 1971 to Oct 31 1971: Commando Hunt VI
    Select Unselect
  • Jul 01 1971 to Nov 30 1971: Consolidation I
    Select Unselect
  • Nov 01 1971 to Mar 29 1972: Commando Hunt VII
    Select Unselect
  • Dec 01 1971 to Mar 29 1972: Consolidation II
    Select Unselect
  • Mar 30 1972 to Mar 28 1973: Vietnam Cease Fire
    Select Unselect
  • Apr 29 1975 to Apr 30 1975: Operation Frequent Wind
    Select Unselect

    If you are sending a Check or Money Order please indicate:

    • I will mail a Check along with my application and documentation. The Library will receive my envelope within 10 days from today.
    • I will mail a Money Order 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
      American Express
      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...

    (USPS Priority Mail shipping fee is included in the totals)

    I want to purchase the Full Color...

  • PDF emailed ($7.50) (No shipping fee)
  • Document shipped ($26.60)...
       Document only with wallet card ($32.60)
  • Document shipped in Bond Enclosure ($31.60)...
       Document in Bond Enclosure with wallet card ($37.60)

  • 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.)
    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)?

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

  • 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 (Form 201-A)
  • No, I will accept my Award Report without my DD-214 appearing in my Award Report (Form 201-A)

  • 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. 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. Name-Personalized items such as Certificates that are produced uniquely for a recipient may not be exchanged or returned.)

    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)
    Policy Statements On Display Recognitions and Hardwear
    Personalized items shipped or emailed with a name and SN/PSN number cannot be returned or refunded. 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..