Brevet Colonel Application Please enable JavaScript in your browser to complete this form.Your Rank:Please SelectPVTPFCSPCCPLSGTSSGSFCMSG1SGSGMCSM2LT1LTCPTMAJLTCCOLBGMGLTGGENWO1CW1CW2CW3CW4CW5GS1GS2GS3GS4GS5GS6GS7GS8GS9GS10GS11GS12GS13GS14GS15Dr.Mr.Mrs.Ms.POC: Your Name *FirstLastYour Email *Your Phone No: *Awardee Rank: *Please SelectPVTPFCSPCCPLSGTSSGSFCMSG1SGSGMCSM2LT1LTCPTMAJLTCCOLBGMCLTGGENWO1CW1CW2CW3CW4CW5GS1GS2GS3GS4GS5GS6GS7GS8GS9GS10GS11GS12GS13GS14GS15Dr.Mr.Mrs.Ms.Awardee Name: *FirstLastSuffix:Awardee Branch:Examples: Engineer, Aviation, Infantry, etc. Full Name for Certificate: *Please write name as you would like it to appear on the Award Medal & Certificate. Award Presentation Date: *If application is submitted within 30 days of anticipated Award presentation date, a $25 fee will be applied for expedited processing.Award Presentation Event:Examples: Signal Ball, Retirement Ceremony, etc.Awardee Contribution to the Regiment or the Association: *Please explain how awardee has made significant contributions to the Regiment or the Association. Delivery Option: *Ship AwardPick Up (Ft. Gordon/Augusta Area)Preferred Contact Method: *CallTextEmailYou will be contacted via the chosen method when your award is ready.Award Shipping Address: *Address Line 1Address Line 2CityPlease SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNameSubmit