Questions About This Form? Use Email

The United States World War One Service...
or Honorable Discharge Lapel Pin Display Recognitions
The WW1 hardwear pins are no longer manufactured by the US government

INSTRUCTIONS:

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. 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 NAVPERS 553, 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:
  LIVING
  DECEASED
  KILLED IN ACTION

Rank Title (Please Do Not Abbreviate):

Date Entered Service:

Date Discharged:

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  

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

    Address:
    City:
    State:
    ZipCode:
    Phone (NO SPACES OR DASHES):

    Your full and complete contact email address:

    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...

    This section for Charge Card and Debit Card applicants. If you are sending a Check or Money Order please skips this section:

    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...

    TOTAL ADMIN PROCESSING/DELIVERY:

    SELECT DISPLAY RECOGNITION TYPE
    The WW1 hardwear pins are no longer manufactured by the US government:

    WW1 Honorable Service document only (no pin) $24.50
    WW1 Honorable Service bond enclosure (no pin) $29.50

    WW1 Victory document only (no pin) $24.50
    WW1 Victory bond enclosure (no pin) $29.50

    WW1 Victory, Wounded in Action document only (no pin) $24.50
    WW1 Victory, Wounded in Action bond enclosure (no pin) $29.50

    Both Honorable and Victory document only (no pin) $36.45
    Both Honorable and Victory bond enclosure (no pin) $46.45

  • Would you like the full-color Wallet-Size Card Certificate along with one of the above full-size color Certificates (Wallet Cards are available only when a paper-published Certificate (not emailed Certificate) has been requested.)
    Yes, Unlaminated ($3.50)
    Yes, Laminated ($6.00)
    No

    LAMINATED WW1 VICTORY PIN PATCH FOR SHADOWBOX DISPLAY
    Would you like the Patch if it is available? (This laminated patch is designed for your Shadowbox and not for wear on a military uniform)


  • No, I do not want the patch.
  • $8.75 -- Yes, if a SILVER laminated patch is available, please include for display in my Shadow Box.
  • $8.75 -- Yes, if a GOLD laminated patch is available, please include for display in my Shadow Box.

    • LAMINATED WW1 HONORABLE SERVICE PIN PATCH FOR SHADOWBOX DISPLAY
    Would you like the Patch if it is available? (This laminated patch is designed for your Shadowbox and not for wear on a military uniform)


  • No, I do not want the patch.
  • $8.75 -- Yes, if a laminated patch is available, please include for display in my Shadow Box.

    • 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.)
    Address
    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)?

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

    • 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
  • No, I will accept my Award Report without my DD-214 appearing in the Report

    • 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 email a copy of your military document(s).

    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)

    LINK: Policy Statements On Display Recognitions and Hardwear
    Name-personalized items that are produced uniquely for a recipient may not be exchanged or returned. However, although typographical errors are very rare, there is no time limit on requesting corrections to errors.

    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.

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