Legion of Valor of the USA - Member Application

Legion of Valor of the USA - Member Application

New Member Application
Applicants may submit this form or print it and email it to adjutant@legionofvalor.org. The following will be required to complete this form:

1 A copy of the general order which lists the award qualifying you for membership in the Legion of Valor

2 A copy of the award citation

3 An individual picture (recent or at time of award) as long as it is of sufficeint resolution to print

There is no membership fee for medal recipients of associate members.
CONTACT INFORMATION - MEDAL HOLDER or Direct Descendant Sponsor if MEDAL HOLDER is deceased.
Name of Medal Holder *

Prefix First Name Middle Name Last Name Suffix
Name of Sponsor is medal holder is deceased

Prefix First Name Middle Name Last Name Suffix
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *

Area Code Phone Number
Upload Picture (Recent or Military)

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EMPLOYMENT INFORMATION
Employer
Title/Position
GENERAL INFORMATION
Date of Birth *

Month Day Year
Date
Place of Birth
Spouse's Name
Nearest Relative

First Name Last Name
Address of Nearest Relative

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Application Recommended By
Not required
This application is being submitted by

Medal Holder Direct Descendant of Medal Holder
If application is being submitted by a direct descendant, indicate relationship to medal holder
MILITARY INFORMATION FOR MEDAL HOLDER
Service Branch *
Highest Rank Held *
Current Status *
I am a legal recipient of the following qualifying medal *
Upload General Orders Awarding the Medal *

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Upload Copy of Citation *

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Summarize Military Service (or attach military bio)
Upload Military Biography

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If applying as an Associate Member, name of Medal Recipient

First Name Last Name
We will send you a separate application to the email address below:
Your Email
example@example.com
Comments (not required)
Thank you for submitting your application. We look forward to validating your information and welcoming you to the Legion of Valor of the USA. Application processing may take up to 10 business days.

Select the SUBMIT button below to complete your application.
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