DEPARTMENT OF ADMINISTRATION

VETERANS SERVICE

Print Application - to complete and mail offline

vETERANS Service Medal application

Honoring the Sacrifice and Service of Our Veterans

Applicants for the Atlantic County Veterans Service Medal are still eligible to receive the medal by mail. Thank you for your interest. Please call 343-2223 if you have any questions.

On-Line Application Directions:

IMPORTANT: All Applications will still need to be printed and mailed to ensure that documentation is correct.

Complete the application page, below. Important: Be sure to provide a phone number either for the Veteran or for the person submitting the application.
Click On the "Submit the Application" button at the bottom of this page. If you did not include a phone number you will be prompted for that information.
You will be taken to a page where you are asked to review the information, update it as necessary and print it when ready. Follow the instructions in the box with the red border in the upper right hand column of that page.
Mail a copy of the completed application along with all necessary documents: a copy of veterans separation papers (DD-214, Form 53-55 or 553) and proof of current Atlantic County residence (copy of utility bill, bank statement, tax bill, drivers license) or copy of death certificate for posthumous candidates to the address provided at the bottom of the printed application.

EliGibility Criteria

Veteran served in the armed forces of the United States during wartime or peacetime
Veteran received a discharge other than dishonorable or for misconduct, unless he/she died prior to separation
Veteran is a current Atlantic County resident, or was a resident when he/she entered military service, or was a resident at the time of his/her death

Eligibility will be verified on an individual basis. Additional documentation may be required.

Veteran Information
	Living Deceased
First Name:
Middle Initial or Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
Date of Birth:
Service Number or Social Security Number:
Branch of Service:
Rank Held Upon Discharge:
Month and Year Veteran Entered Active Duty or Mobilized:
	Month: Year:
Month and Year Veteran Exited Active Duty or Demobilized:
	Month: Year:

Applicant Information (If other then the veteran)
Relatives or friends of the veteran may apply for the medal on the veteran’s behalf. However, medals will only be provided to the veteran or veteran’s next of kin. Due to a limited supply, only one medal per veteran will be issued. No medals will be sold or provided to collectors.
Name of Applicant (other than the veteran)
First
Last:
Address:
City:
State:
Zip Code:
Phone:
Relationship to Veteran:

select how to receive medal
U.S. Mail - delivered directly to eligible veteran or next of kin. Mail to: None (Ceremony) Veteran Applicant (must be Next-of-Kin) Other (Next-of-Kin) If other, Mailing recipient’s name and address: Name: Address: City: State: Zip:

	Atlantic County Government DEPARTMENT OF ADMINISTRATION Veterans Services