Arizona Department of Veterans’ Services
Honorary Diploma Application
APPLICANT INFORMATION
First:
M.I.
Last:
Jr.,Sr.
Full Mailing Address:
Phone:
Email:
Is the diploma being awarded posthumously?
If yes, indicate place and date of death:
If yes, what is the name of the person applying on behalf of the deceased veteran?
If yes, what is your relationship to the veteran?
Please check the appropriate boxes below:
Recipient served in the U.S. military during World War II, the Korean Conflict, or Vietnam and was
honorably discharged?
Recipient was scheduled to graduate from high school in the years the war or conflict took place?
Recipient currently resides in Arizona?
Verification Documents Required: Please provide documented evidence that you enlisted in the armed
forces of the United States before completing high school in a public or private school. In addition, please
provide verification of military service and honorable discharge. Discharge papers may be requested from
the National Archives and Records Administration by completing an online application or by filing out a
Standard Form 180 and mailing/faxing it in. The form may be obtained from the web at https://
www.archives.gov/veterans/military-service-records or by calling (314)801-0800.
Name of high school from which to request the diploma:
Name of School:
State:
Signatur
e: _________________________________ Date: _____
_____________________
Yes
No
Yes
No
Yes
Yes
No
No
Return completed form to:
Arizona Department of Veterans’ Services
3839 N. 3
rd Street, Suite 209 Phoenix, AZ 85012-1570
Email to: benefits@azdvs.gov
Revised 08/20/2020
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