Personalized Certificate of Service
Information Form

Fill out the information, then click the
"Submit" button at the bottom of the page.
We guarantee all of your information will be held confidential.
Contact Information
We will be contacting you with image proofs of your certificate and any questions we may have. Please give us the your full contact information.

Your Name:


City:   State: Zip:

Telephone Number:

Secondary Number:

E-Mail Address:
Unless requested otherwise, we will be sending image proofs by e-mail.

Military Certificate Information
Name on Certificate:
Veteran? or Retired?


Navy or Coast Guard Rating:

Wars or Operations, If Served:


Service From/Since: and/or To:

Awards: If you do not have your awards handy that's fine. We will be in contact by email.

How did you find out about us?

When you click on the Submit button below your certificate information will be sent to us. You will be taken to a payment page to finalize your order.

Click once. Thank you for your patience.

Satisfaction Guaranteed!

CJM Military Certificates

If you would rather pay by phone:

Arizona: 1 (928) 978-0729
Toll Free: (866) 447-1011