Certicates of Appreciation for Peace Operations will be issued as “Peace Operations” and will not specically note the theatre of
operations (e.g. Peace Operations in the Balkans will be issued as “Peace Operations”).
D0755 - 02/20 - p1 of 3
Korea Malaya Malaysia Thailand Thai–Malaya Vietnam
Saluting their Service
Application for Certicate of Appreciation
Your personal information is protected by law, including the Privacy Act 1988. Your personal information may be collected by the Department of
Veterans’ Affairs (DVA) for the delivery of government programs for war veterans, members of the Australian Defence Force, members of the Australian
Federal Police and their dependants.
Read more: How DVA manages personal information
AUSTRALIAN SERVICE 1945–75
Balkans
Afghanistan Cambodia East Timor ICAT (International
Coalition Against
Terrorism)
Iraq
Iraq 2003
Kuwait Middle East Namibia South East Asia Rwanda
Sierra Leone Somalia
AUSTRALIAN SERVICE SINCE 1975
Berlin
FESR (Far East
Strategic Reserve)
Germany Indonesia Japan Kashmir
Korea Middle East
Thailand West New Guinea
Papua New Guinea South East Asia Special Operations South West Pacic
PEACE OPERATIONS 1945–75
Balkans
Bouganville Cambodia Counter
Terrorism/Special
Recovery (CT/SR)
East Timor Ethiopia/Eritrea
Kashmir Korea Kuwait Lebanon Middle East Mozambique
Peshawar Rhodesia South East Asia Sinai Solomon Islands I Solomon Islands II
Somalia
South Pacic
2006
South Sudan
Uganda
West Sahara
Special Operations Sudan Timor–Leste
PEACE OPERATIONS SINCE 1975
Second World War
Border
Protection
Greater
Middle East
Operations
AUSTRALIAN OPERATIONAL SERVICE MEDAL
Guatemala
Gulf Haiti Iran/Iraq Iraq Irian Jaya
Privacy notice
IMPORTANT
Surname
Given name(s)
Telephone number
(daytime contact)
POSTCODE
Section A Person whose name will appear on the certicate
( )
Address
No
Yes
Date of Birth
/ /
Surname
Given name(s)
Section B Details of person making the nomination
Address
D0755 - 02/20 - p2 of 3
Telephone number
(daytime contact)
Relationship to person for whom you
are applying
Are you making application for a
posthumous award?
Type of contribution or service
Section C Details of service
Where was the contribution or
service made?
Nature of contribution or service
Military
Civilian
Dates of contribution or service
From
to
Australia (Second
World War only)
Overseas
If overseas, in which country?
Evidence of service in respect of
Certicate(s) claimed
If you are applying for yourself, please go to Section C
If you are applying on behalf of another person, please go to Section B and then complete Section C
( )
POSTCODE
/ /
/ /
Date
Signature
Section D Presentation of award
This application should be forwarded to the electorate ofce of your local Federal Member of Parliament.
Presentation of your Certicate of Appreciation will be organised in conjunction with your local Federal Member.
I hereby declare that the information supplied by me in this form is complete and correct.
/ /
D0755 - 05/18 - p3 of 3
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