Application for Honours and awards for Retired Members of the Canadian Forces

Recipient’s Military Service
Applicant Address
Application Type
List of Medals
Additional Comments/Information
Applicant Agreement

Recipient’s Military Service

Last name

First name

Initials

Date of birth (YYYY-MM-DD)

Enrolment date (YYYY-MM-DD)

Release date (YYYY-MM-DD)

Rank

Service/Regimental Number

Applicant Address Information

First name, last name, initial is the same as Recipients Military Service Information

Country

Canada
United States of America
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma (Myanmar)
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China (People’s Republic of)
Colombia
Comoros Island
Congo
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia (Federated States of)
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (Republic of)
Norway
Oman
Pakistan
Palestinian Authority (Gaza)
Palestinian Authority (West Bank)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Sudan
Suriname
Eswatini
Sweden
Switzerland
Syria
Tahiti
Taiwan (Republic of China)
Tajikistan
Tanzania
Thailand
Timor-Leste (Timor oriental)
Togo
Tonga
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
US Virgin Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe

Telephone

Telephone (alternative)

Email address

Application Type Information

Applications for both initial issue of medals and for the replacement of lost or stolen medals will need to be done through the submission of two application, one for initial issue and one for replacement.

Application Type

Initial
Replacement

While the initial issue of medals is provided at Crown expense, the replacement of medals is done at cost and paid for by the requestor. Do not send payment now, DH&R will make contact once the application has been validated to advise of the final cost.

Is the member “Deceased/Incapacitated CF Member”

Presentation

Select presentation method

I want the award(s) sent by mail to the address provided above
I have contacted a sponsor and this person or organization has agreed to present the award(s)

Sponsor organization

Title (if applicable)

Contact last name

Contact first name

Ship to Address

Country

Canada
United States of America
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma (Myanmar)
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China (People’s Republic of)
Colombia
Comoros Island
Congo
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia (Federated States of)
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (Republic of)
Norway
Oman
Pakistan
Palestinian Authority (Gaza)
Palestinian Authority (West Bank)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Sudan
Suriname
Eswatini
Sweden
Switzerland
Syria
Tahiti
Taiwan (Republic of China)
Tajikistan
Tanzania
Thailand
Timor-Leste (Timor oriental)
Togo
Tonga
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
US Virgin Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe

Telephone

Telephone Alternative

Email address

Steps taken to recover medals if possible

Statutory Declaration

Canada, Province of

If outside Canada, show place where taken

In the matter of the Application for replacement of lost/destroyed/stolen medals:

I (full name)

a retired member of the Canadian Armed Forces, make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Todays Date: (YYYY-MM-DD)

Reference Information

Provide a reference who can corroborate that the above is true.

Last name

First name

Address

City

Province

Postal code

Telephone

Telephone Alternative

Canadian Medals Chart List Information

UN Medals: The UN strictly applies their medals policy and will not consider requests for initial issue of UN medals that are submitted more than one year after repatriation from the mission area.

NATO Medals: NATO strictly applies their medals policy and will not consider requests for initial issue of NATO medals that are submitted more than two years after repatriation from mission area.

Additional Comments/Information

Additional Comments/Information:

Applicant Agreement (required)

By checking this box, I declare the information provide above to be true and correct and this is considered my Applicant Signature

If you find any technical difficulties when submitting this form, please contact web support at dnd.webposting-publicationweb.mdn@forces.gc.ca.

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Date modified:: 2024-12-20

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Application for Honours and awards for Retired Members of the Canadian Forces

Recipient’s Military Service

Applicant Address Information

Application Type Information

Presentation

Statutory Declaration

Reference Information

Canadian Medals Chart List Information

Additional Comments/Information

Page details