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Australian Service 1939-45 Medal
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 documentation confirming military service.

    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:

    Rank Title (Please Do Not Abbreviate):

    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:

    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 Entered military service:

    Date Discharge from military service:

    If you are sending a Check please indicate:

    • I will mail a Check 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...

      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:

      I want to purchase the Full Color...

    • PDF emailed (full color, printable) ($7.50) ( RECOMMENDED, No USPS shipping fee )
    • Document shipped ($27.43)...
         Document only with wallet card ($33.43)
    • Document shipped in Bond Enclosure ($32.43)...
         Document in Bond Enclosure with wallet card ($38.43)

      • (The shipping totals above include the USPS - Priority Mail shipping fee)

      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

      • 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.

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