Phone: 1-562-422-4100

Vietnam Combat Campaign Service
Replacement Recognition Application Form

INSTRUCTIONS:

    1. Complete this form in full.
    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

    Service Branch:

    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:


    Full and complete contact email address:

    Please enter the FIRST EIGHT DIGITS ONLY of the Recipient's Service Number:

    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 USPS 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 USPS 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
      Visa
      MasterCard
      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...

    TOTAL ADMIN PROCESSING/DELIVERY:

  • .PDF Emailed - $7.50 Full Color
  • U.S. delivery - $22.35 Full Color Document Only
  • U.S. delivery - $27.35 Full Color Document in Bond Enclosure
  • I do not want the Display Recognition. I am requesting the hardwear items listed below (medal, badge, ribbon or patch) if they are available for this award. (Shipping cost applies to non-certificate requests.)
  • Would you like the full-color Wallet Size Certificate along with one of the above full-size color Certificates ($3.50) Yes No
    SKIP THIS SECTION IF YOU ARE NOT REQUESTING A CD-ROM...
    I want Certificates in pdf format on a CD rom...


  • I want of my Certificates (minimum 20) in full color; $7.50 per Certificate on CD-ROM. I will be emailing a list of the Certificates I want

  • No CDrom

    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)

  • 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 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 using the internet through the United States Post Office after it has been shipped (for seventy-five [.75] cents extra)?

  • Yes, add 75 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. 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
    Policy Statements On Display Recognitions and Hardwear

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