To ensure ease of use and proper processing of data, please read the following instructions. It is imperative that all instructions be followed so that Requests for Medals can be processed without delay. Please verify that your data input is accurate prior to printing this form. This application does not feature an "undo" button.
This form is to be used to make application for the initial issue of individual service medals or replacement of lost decorations and medals. This form can be used for the following medal types:
NOTE: It is imperative that a Signed and Dated hard copy of this application be sent to our office. Your application will not be processed until our office receives the hard copy of this request. Therefore, after entering all data required, print a copy of this form, Sign and Date it at the bottom of the application. You must MAIL the hard copy.
- Orders of merit (i.e. the Order of Canada or the Order of Military Merit) - replacement only;
- Military Valour Decorations - replacement only;
- Canadian Bravery Decorations - replacement only;
- Meritorious Service Decorations - replacement only;
- Mention-in-Dispatches - replacement only;
- Chief of the Defence Staff and Command Commendations - replacement only;
- War and operational service medals - initial issue and replacement;
- The Special Service Medal (SSM with all bars) - initial issue and replacement;
- The Canadian Peacekeeping Service Medal (CPSM) - initial issue and replacement;
- United Nations, NATO and International Community medals - initial issue and replacement;
- The Canadian Forces Decoration (CD) - initial issue and replacement; and
- British orders, decorations or medals
that were available prior to the expansion of the Canadian
honours system in 1972 - initial issue and replacement.
An application(s) when completed is considered Protected B. DO NOT FAX OR E-MAIL any application forms nor substantiating documentation.
SUBMIT BY MAIL ONLY to:
Directorate of History and Heritage (DHH) 4-3
Bldg 347 Uplands Site
MGen George R. Pearkes Bldg
101 Colonel By Drive
Canada K1A 0K2
Engraving of the Canadian Forces' Decoration
NOTE: The member's rank will be engraved in the language of the application. For English ranks (e.g. MCPL ) application must be made using the English form, and for French ranks (e.g. CPLC) the French form must be used.
If available, please send Proof of Service with this Request. If Proof of Service is not mailed in with the hard copy of your Application we cannot ensure that your Application will be placed in priority sequence.
Medal Application for Retirees/Civilians
Retired Members should include all service numbers they have held during their service career, as this will facilitate document retrieval at the National Archives of Canada.
- Service Number: Input the current Service Number if known. This is a nine-digit number, beginning with an Alpha character (e.g. A12 345 678);
- Old Service Number: During approximately a 20-year period Social Insurance Numbers were used to identify service personnel while they served in the Canadian Forces. This field is optional and should only be entered if the applicant wishes to do so. Once printed, fill-in by hand.
- Regimental Number: Once printed, fill-in by hand a regimental number if known.
- Last Name: Input last name of member.
- Initials: Input initials of member.
- First Name: Input first name of member.
- Release Date: Input the release date of member.
- Deceased Date: If you are applying on behalf of someone else and that person is deceased please provide the date of death.
- Rank: (Pick List - a drop down list box is provided for this field)
Input the rank held at time of release. If this field does not apply please select the N/A option.
- Enviro. Code (Environmental Code): (Pick List - a drop down list box is provided for this field)
This field pertains to the service element, i.e. Land, Sea or Air. Provide environment code of member at time of eligibility. If this field does not apply please select the N/A option.
- Member Type: (Pick List - a drop down list box is provided for this field)
Select the appropriate member type. Options are:
- Serving Members. Serving members should not use this application form, as application will be done by your URS;
- Retired CF Members;
- Police - Former members of the Canadian Forces who are now members of the Royal Canadian Mounted Police or other Canadian police forces can be presented their medals under arrangements made by the RCMP; or
- Civilians - In accordance with Bill
C-300 a Canadian citizen who serves at the invitation, by
the nomination, or with the agreement of the Government of
Canada, with a peacekeeping force, is eligible for the CPSM.
To be awarded a medal a Canadian citizen must demonstrate
that one of these conditions have been met. Civilian
recipients are requested to provide documentary proof along
with a type written explanation.
- Eligibility Unit: (Pick List - a drop down list box is provided for this field)
Provide the unit of member at time of eligibility. If this field does not apply to you please select the N/A option.
13. Eligibility Rank: (Pick List - a drop down list box is provided for this field)
Provide the rank of member at time of eligibility. This is required if you are applying for the replacement of your Canadian Forces Decoration. If this field does not apply to you please select the N/A option.
- Eligibility Rank: (Pick List - a drop
down list box is provided for this field) Provide the rank of
member at time of eligibility. This is required if you are
applying for the replacement of your Canadian Forces Decoration.
If this field does not apply to you please select the N/A
- Medal Type: (Pick List - a drop down list box is provided for this field)
Please select the medal that is being applied for, e.g. CD, SSM, CPSM, etc. Note that the drop down list only contains current Canadian medals. For other medals please type all the medal names in the Notes field, e.g. 1939-45 Star, Atlantic Star, CVSM, etc.
- Replacement: (Checkbox - selecting this checkbox signifies that the request is for a replacement of a medal previously awarded to the individual)
Indicate if this application is for the replacement of a lost or stolen medal.
- Qualifying Period: Provide dates of service time for that qualifies the individual for requested medal.
- Notes - Dates and Place of Duty: Input
any amplifying information that proves qualification for the
Notes for CPSM Applications
The CPSM will recognize service by Canadians deployed outside Canada for a minimum of 30 days (not necessarily consecutive) either on the strength of a unit of the Canadian Forces deployed on a peacekeeping or observer mission, or in direct support of any such mission. This will include members of the Royal Canadian Mounted Police, other Canadian police officers and civilians who served with such forces.
As the CPSM is a peacekeeping medal, only service on peacekeeping operations (UN Chapter VI or equivalent) will qualify the individual for the medal. Operations conducted under the authority of UN Chapter VII (or equivalent) do not qualify the individual to receive the CPSM. These operations include:
- Service in Korea from 27 June 1950 to 27 July 1954,
- Service in the Arabian Gulf from 2 August 1990 to 27 June 1991, or
- Service in Somalia from 16 November
1992 to 30 June 1993 as a member of OPERATION DELIVERANCE.
Additionally, service on humanitarian missions does not qualify the individual to receive the CPSM. For personnel who have served on more than one qualifying operation it is not necessary to list all operations, as one will suffice. ALL eligible, non-eligible and HMCS Missions and Operations can be found in the drop down menu on the CPSM Page.
Next of Kin Information
Please indicate if you are applying for medals on behalf of someone else by clicking on the Checkbox, which states "Are you submitting this Application on behalf of someone else?"
Please complete the fields under the Next of Kin Information section.
Mailing Address Fields
- Last Name: Input the last name of the Next of Kin who is making the application.;
- Initials: Input the initials of the Next of Kin.
- First Name: Input the first name of the Next of Kin.
- Relationship: Identify your
relationship to the individual on whose behalf application is
Presenter's Information Fields
- Next of Kin/Individual to receive award Options: Selection of one of these options is essential. If you select the "Next of Kin" option the mailing address will represent the Next of Kin. If you select the "Individual to receive award" option the mailing address will represent the Individual to receive the award.
- Email: If you would like correspondence through email please fill in your email address.
- Address1, Address2, City, Province, Postal Code, Country: Please include the complete mailing address.
- Home Phone, Work Phone, Fax Number:
Please include at least one telephone number where you can be contacted.
Note on CPSM Presentation
The CPSM must be individually presented to each recipient at either a formal or informal ceremony. You may select the Branch President of the Royal Canadian Legion, an executive of a peacekeeping veterans association, or any other veterans association to award you this medal. You also have the option to have the CPSM presented to you by a close friend, a member of your family, a religious or a civic leader in your community.
The CPSM Project Office's role is to make every possible effort to respect your wishes on this matter while conforming to the letter and spirit of the legislation and the direction issued to us by the Government of Canada. It is important to inform the CPSM Project Office of your wishes in this matter.
Please indicate who you wish to present you the medal.
- Sponsor: Provide the Sponsor you wish to present the medal to you i.e. The Royal Canadian Legion.
- Contact Last Name: Provide the last name of the contact who represents the Sponsor you wish to present the medal to you.
- Contact First Name: Provide the first name of the contact who represents the Sponsor you wish to present the medal to you.
- Email: Provide the email address of the Sponsor, if known.
- Address1, Address2, City, Province, Postal Code, Country: Provide the complete mailing address of the Sponsor you wish to present the medal to you.
- Home Phone, Work Phone, Fax Number:
Provide at least one contact number of the Sponsor you wish to
present the medal to you.
If you have any questions concerning your eligibility for the Canadian Peacekeeping Service Medal please contact the CPSM Project Office at (613) 990-4446, 1-877-741-8333 or by fax at (613) 990-6289.
For all other medals, please contact the
Honours and Awards Distribution Cell Supervisor at
(613) 991-3957, 1-877-742-8332 or by fax at (613) 990-4390.
Once you have read and understood the instructions listed above please advance to the Medal Request Application by clicking on the hyperlink below:
APPLICATION FORM FOR
RETIRED MEMBERS OF THE CF AND CIVILIANS (Canadian Citizens)