Medal Application


You are applying for Medals in the Australia, New Zealand, Asia area (SAMVOA).
If this is incorrect please select your area from the drop down list.


Instructions

  1. For all applicants, e.g. General Service medal, please fill in Section 1.
  2. If you have done service in Mozambique (including Comores), South West Africa (Walvis Bay not included),
    complete Section 1 and Section 2.
  3. If you have participated in cross border operations into Angola also complete Section 3.
  4. Please include as much information you can or that you remember about your service in the additional information boxes.
  5. If you are enquiring about lost certificates or stolen/lost medals, please fill in Section 1, but in the ‘Any other relevant information’ please list all the medals and their numbers you have in your possession and put an X in the Issue of Certificates box or Re-issue of lost/stolen medals.
  6. Ensure that your up to date postal address is included then sign your application. (This is in the declaration part).
    NB: THE MEDALS WILL BE DISPATCHED TO THE ADDRESS THAT YOU PROVIDED IN THE FORM.
    THE MEDALS CANNOT BE RESENT TO ANOTHER ADDRESS.
  7. Please double check your completed application before submitting your application.

Medal Questionnaire - Australasia Area (SAMVOA)

CONFIDENTIAL

Section 1

Please fill in as much information as you can. This will assist in tracing the correct records from the archives and establishing which medals you may be entitled to. It will save a lot of time. If you cannot remember your force number then your ID number will be sufficient.
* required field.

ID number *
Force number *
Full Names *
Surname *
Service Start Date *
Service End Date *
Unit First *
Unit Last *
Rank *
Email Address *
POSTAL Address *
City *
State/Territory *
Postal Code*
Country *
Phone Number *
MobileHomeWork
Application For * Issue of Medals and CertificatesIssue of CertificatesRe-issue of lost/stolen Medals
Medals Applying For *

Notes:
Please provide as much information as you can. This will assist in tracing the correct records from the archives saving time. If you cannot remember your force number then your ID number will be sufficient. If your medal/s have been awarded they will despatched directly to your postal address. Please ensure that this information is up to date. In the event of any queries or if clarifications are required, we will make every attempt to contact you via the information you have provided.

Section 2

Were you involved in duty in anywhere in South West Africa. If you were based at any of the units in South West Africa, please fill in as much information as you can, including dates and units and platoon commander, if known.

Start End Unit Rank Unit and Utilisation (Aanwending) Platoon Commander
Additional information
about your service

Notes:
Please provide as much information as you can. This will assist in tracing the correct records from the archives saving time. This will assist in tracing the correct records from the archives saving time verifying the information.

Section 3

Were you involved in operations into Angola? If you were involved in any operations across the border, please provide as much information as you can about the name of the operation, dates and your Platoon Commander.

Start End Operation Rank Unit and Utilisation (Aanwending) Platoon Commander
Additional information
about your service

Notes:
Please provide as much information as you can. This will assist in tracing the correct records from the archives saving time. This will assist in tracing the correct records from the archives saving time verifying the information.

Declaration:

I understand that it is an offence to make a false or deliberately misleading statement in support of an application.

I (Full Name) make this declaration conscientiously believing the same to be true.

By clicking I hereby ubderstand that I am electronically signing my application.
Signature *

Please ensure that you receive "Your message was sent successfully. Thanks." in a green border after clicking the Submit button.
If not, your massage was not received.