Korea Peace Medal application

Please provide the following information and forward to PEI Provincial Command office:

Full Name:
Date of Birth:
Service date in Korea:
Service Branch (Army, Navy, Air Force):
Service Number:
Regiment during the Korean War:
Rank during the Korean War:
Address:
Telephone Number:
Have you had the opportunity to return to Korea with the ¨Revisit Korea¨
program? Yes ____ NO ____
Are you a member of KVA (Unit ?) or RCL (Branch ?)
*Please provide a copy of the veteran’s certificate of release or discharge
from active duty for verification purpose.