l>Golden Dragon, Plank, Shellback, golden Shellback, Panama Transit, Equator display Recognition Replacement application Form

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Domain the the golden Dragon, Plank Owner,Plank Preserver, Shellback, gold Shellback,Arctic Circle, Panama Transit and also EquatorReplacement screen Recognitionand/or Wallet Card applications Form


1. Finish this kind in full. ( Click here to email amerwar
amervets.com if friend have any kind of technical difficulties sending this Application kind after you have actually completed the )2. Click the switch at the bottom the this completed form to email it come The war Library, together with a star chep of the compelled document(s) explained on the indict Page, or you can Print and mail this type and the required papers to the Library"s mailing deal with below.

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Do not Hilite, Underline, Circle, ColorizeOr note In Any way The DD-214Or other Military document PhotocopyYou will Be Sending.

Charge map or Debit map applicants: come expedite delivery of your Replacement acknowledgment you may email this kind today. Your Replacement recognition will it is in prepared and awaiting the come of your DD-214 or other, pre-arranged army document(s).

Which Qualification: please select...Crossing the line (Date Line)Crossing the heat (Equator)Plank OwnerPlank PreserverShellbackGolden ShellbackDomain the the gold DragonNorthern Domain that the Polar BearPanama TransitRealm that the Arctic Circle

Country Name only of destination (DO NOT provide City or port name):

Recipient"s LAST surname (as it shows up on the Report that Separation):FIRST name (as it appears on the Report that Separation):MIDDLE surname (as it shows up on the Report the Separation):Title (Must show up on military documentation):JrSrIIIIIIV

Is this veteran at this time living, deceased or KIA:LIVING DECEASED killed IN action

Rating or Rank title (Please carry out Not Abbreviate):

PaygradeEnlisted you re welcome select...E1E2E3E4E5E6E7E8E9E10Warrant you re welcome select...W1W2W3W4W5Officer please select...O1O2O3O4O5O6O7O8O9O10I have actually not moved. My current resolve info is on document from a vault application

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

Full and complete contact email address:SERVICE NUMBER:Enter the veteran"s an initial FOUR digits ONLY(Do not enter any kind of alphabet letters. Numbers only.)Enter the 2nd FOUR (or remaining) number ONLY

Please complete only the section of the Certificate you space requesting...

DOMAIN that THE DRAGON:Name the vessel date vessel overcome Intl day Line:

SHELLBACK (Vessel Travel)Name the vessel: day Crossed Equator: Time overcome Equator (leave this field empty if you execute not mental the time): Latitude (leave this field blank if you perform not understand the latitude): Longtitude (leave this field empty if you do not know the longitude):

GOLDEN SHELLBACK (Vessel Travel)Name the vessel: day Crossed Equator: Time overcome Equator (leave this field blank if you do not remember the time): Latitude (leave this field blank if you do not recognize the latitude): Longtitude (leave this field blank if you carry out not know the longitude):

PANAMA TRANSIT (Vessel Travel):Name of vessel date vessel transited the Canal:

CROSSING THE line (Vessel or waiting Travel):Date girlfriend flew over the day Line: army or advertisement Aircraft?

CROSSING THE EQUATOR courage or (Air Travel):Date girlfriend flew over the Equator: were you aboard army or advertisement Aircraft?

If you are sending out a check or Money Order please indicate:

I will certainly mail a Check together with my application and documentation. The Library will obtain my envelope in ~ 10 days indigenous today.I will mail a Money Order in addition to my application and also documentation. The Library will receive my envelope within 10 days native today.

CHARGE or DEBIT card applicants:

-- My current Card details is already on record from a previous Application

If your Card info is no on file, please complete the following...

Please choose in between ASAP or Monthly shipping...I to be submitting today) to be shipped As soon As Possible.
Your Name as it appears on your fee or check debit card:

Payment Method
Check DebitVisaMasterCardAmerican ExpressDiscoverDiners ClubCarte Blanche

Card number: Expiration day Card confirmation Number (CVV Code) (See below)

American Express: 4 digits on former of card
All various other cards, 3 digits on back

After print this form for mailing, please authorize here:

International shipping price (U.S. Veteran living external the unified States, please add the shipping price you to be quoted...

TOTAL ADMIN PROCESSING/DELIVERY:I want to acquisition the complete Color... PDF emailed ($7.50) (No shipping fee) file shipped ($24.65)... Record only v wallet map ($30.65) paper shipped in shortcut Enclosure ($29.65)... Paper in link Enclosure v wallet card ($35.65)

(The shipping totals above include the USPS - Priority mail shipping fee)SKIP THIS section IF YOU are NOT REQUESTING A CD-ROM...I desire Certificates in pdf style on a CD rom... I want of my certificate (minimum 20) in complete color; $7.50 per Certificate ~ above CD-ROM. I will be emailing a perform of the Certificates i want

Would you favor an archive (black&white) copy of the Certificate girlfriend are using for to be mailed indigenous the documents Chief directly to your Commanding Officer -or- to your Employer -or- to your school Administrator for inclusion right into your permanent personnel document jacket?(Fee: $3.50) accessible only as soon as a published certificate is requested. Not easily accessible with emailed certificates.

No.Yes, please mail an embossed, B&W copy of my Certificate to the adhering to person and address:

Official"s nameOfficial"s TitleOfficial"s company Name (name that unit, vessel, office, school, etc.) AddressCity, State, Zip

Would you prefer a released copy of My armed forces Medal last Will and also Testament?

Yes, please incorporate a Medal will certainly for a masculine heir of my medals and add $4.00 to mine totalYes, please encompass a Medal will certainly for a female heir of mine medals and add $4.00 to mine total

Would you like to track your package v the joined States write-up Office after ~ it has been shipped (for twenty <.20> cents extra)?

Yes, add 20 cents to my totalNo, ns don"t want to track my package

Ignore this last Question if you will certainly EMAIL or have actually previously EMAILED a copy her DD-214...Would you choose your mailed DD-214 scanned by The war Library and also integrated into your 201A award Report that will certainly be emailed come you once your requested item(s) are sent to you? The scanning fees is $3.00 (a one-time fee)

Yes, include a one-time $3.00 to my total to Scan and also Integrate mine DD-214 into my award ReportNo, I will accept my award Report without my DD-214 appearing in the Report

Your Application form is now complete. After click the button below to send this form you will soon obtain a confirmation email containing final instructions on which items, if any, are essential to fulfill your request. Your DD-214 can be mailed or emailed. (Non-personalized item such as hardwear may be exchanged or returned within ten days of delivery. Name-Personalized items such together Certificates that are created uniquely for a recipient might not be exchanged or returned.)

Records chef (REC-AMW)The American battle Library817 east Via CarmelitosVirginia building 319Long beach CA 90805-7549Phone: 1-562-422-4100 (Pacific Time Zone)Policy explanation On display Recognitions and HardwearPersonalized items transport or emailed v a name and also SN/PSN number cannot be went back or refunded. However, return typographical errors are an extremely rare, there is no time border on requesting correction to errors.

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