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ORDER FORM
Name_____________________________________________________Officer____Enlisted_____
Address________________________________________________________________________
City_____________________________________ State_______________ Zip________________
Phone__________________________________ Email__________________________________
Commission Date_________________________ Enlistment Date__________________________
Service ___________________________ Rank at Commissioning/Enlistment________________
Signature (black Ink 4")
Send check for: $97 + $12 S&H TOTAL: $109.00 (Virginia residents, add 5% tax/$4.85)
Mail to: OATH, P.O. Box 8222, Charlottesville, Virginia 22901; expect delivery within 30 days.
Thank you for your service to the United States of America!
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