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:


(Please Specify)*

SEND INFORMATION/DOCUMENTS TO:

Name*

Street Address*

Apt.

City*

State*

Zip Code*

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Choose Delivery Method *

Official Copies Via Email $79.00

Official Copies Via Email & Hard Copies Via USPS Mail $99.00

Credit Card Information

Name on Card *

Card Number*

Expiration Month/Year*

I Authorize ARG to Access and Deliver the Records I have Ordered.

Your Signature*

Move the blue-ball into the signature box, and click your mouse to create a written signature. Do your best-it doesn’t have to be perfect.

Click on the signature area and sign the form using your finger. Do your best-it doesn’t have to be perfect.