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FREE Afghanistan Campaign Medal
While Inventory lasts
Replacement Recognition Application Form

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 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.

CERTIFICATE TYPE:

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

Service Branch:

Military (in Afghanistan) Rank Title (Please Do Not Abbreviate):

Civilian (in Afghanistan) Job Title (Please Do Not Abbreviate):

Military Paygrade
Enlisted
Warrant
Officer

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

Address:
City:
State:
ZipCode:
Phone:

Your 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   ☛ 

Date arrived in-country Afghanistan:

Date departed Afghanistan:

If Civilian, Name of Employing Company or Agency:

TOTAL ADMIN PROCESSING/DELIVERY:

I want the Full Color...

  • Document shipped ($27.43)... Includes full-size, U.S. made, Free medal and ribbon
    (Document fee is $14.00. USPS Priority Mail Shipping Fee is $13.43)

  • PDF emailed Document (full color, printable) ($7.50) ( No Medal or ribbon included )

  • If you are date-eligible for the NATO Afghanistan medal, would you like them to be included in your shipment with the ACM for $5.00

    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
      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...

    Would you like to track your package using the internet 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

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.

To email this form click the button below. To mail this form address your envelope to:

Records Chief (REC-AMW)
The American War Library
817 East Via Carmelitos
Virginia Building 319
Long Beach CA 90805-7549

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.

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