Online Order Form

Aardvark Research Group > Online Order Form

Step 1

Veteran Information

Step 2

Military Service Information

Step 3

return address and signature

Step 4

Method of payment

NAME USED DURING SERVICE*

SOCIAL SECURITY NO.*

DATE OF BIRTH (MM/DD/YYYY)*

PHONE NUMBER (CELL PREFERRED)*

EMAIL ADDRESS*

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Service	BRANCH OF SERVICE	YEAR ENTERED	YEAR RELEASED	OFFICER	ENLISTED	MILITARY SERIAL NUMBER
	DATES OF SERVICE (Please Estimate)				CHECK ONE
	BRANCH OF SERVICE	YEAR ENTERED	YEAR RELEASED	OFFICER	ENLISTED	MILITARY SERIAL NUMBER (Pre 1970 Only)
a. ACTIVE SERVICE
a. ACTIVE SERVICE	a. ACTIVE SERVICE	DATES OF SERVICE (Please Estimate)				BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED	CHECK ONE	OFFICER	OFFICER	ENLISTED	ENLISTED	MILITARY SERIAL NUMBER (Pre 1970 Only)
DATES OF SERVICE (Please Estimate)			BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED		CHECK ONE		OFFICER	ENLISTED		MILITARY SERIAL NUMBER (Pre 1970 Only)
b. RESERVE SERVICE	a. ACTIVE SERVICE
b. RESERVE SERVICE	b. RESERVE SERVICE	DATES OF SERVICE (Please Estimate)				BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED	CHECK ONE	OFFICER	OFFICER	ENLISTED	ENLISTED	MILITARY SERIAL NUMBER (Pre 1970 Only)
DATES OF SERVICE (Please Estimate)				BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED		CHECK ONE	OFFICER	ENLISTED		MILITARY SERIAL NUMBER (Pre 1970 Only)
c. ARMY/AIR NATIONAL GUARD	b. RESERVE SERVICE
c. ARMY/AIR NATIONAL GUARD	c. ARMY/AIR NATIONAL GUARD	DATES OF SERVICE (Please Estimate)				BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED	CHECK ONE	OFFICER	OFFICER	ENLISTED	ENLISTED	MILITARY SERIAL NUMBER (Pre 1970 Only)
DATES OF SERVICE (Please Estimate)				BRANCH OF SERVICE		YEAR ENTERED		YEAR RELEASED		CHECK ONE	OFFICER	ENLISTED		MILITARY SERIAL NUMBER (Pre 1970 Only)

HAVE YOU MADE A PRIOR REQUEST FOR YOUR RECORDS WITHIN THE PAST 90 DAYS?

Yes No

INFORMATION
INFORMATION AND/OR DOCUMENTS REQUESTED
DD Form 214 or Equivalent
Other Information and/or Documents Requested Please Explain

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REQUESTER IS:

Military Service Member or Veteran

Next-of-Kin of Deceased Veteran

Legal Guardian or POA

PURPOSE* Please Select one of the Options Below:

Medical Urgent (FASTEST OPTION)
Burial/Funeral
Benefits Urgent


(Please Specify)*

SEND INFORMATION/DOCUMENTS TO:

Name*

Street Address*

Apt.

City*

State*

Zip Code*

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Choose Delivery Method *

EXPEDITED SERVICE (FAST DELIVERY VIA SECURE EMAIL) $89.00

EXPRESS SERVICE (FASTEST DELIVERY VIA SECURE EMAIL) $99.00

Credit Card Information

Name on Card *

Card Number*

Expiration Month/Year*

I Authorize ARG to Copy and Deliver the Military Records I have Requested.

Your Signature*

Clear Your Signature

Please sign the form by clicking on the signature line with
your mouse and moving the blue ball to create a written
signature. We cannot process your order without a signature.

Please click on the signature area and sign the form using your finger. We cannot process your order without a signature.

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