The principal eligibility criterion is that the individual must have been under direct and hostile fire while operating in unsecured space (outside the defended perimeter), or physically engaging hostile forces with direct and lethal fire.
The Commander, Air Force Forces is the award authority for the AFCAM. The award criteria for the AFCAM are similar to that of other U.S. services but are more specific with regard to combat conditions criteria. Personnel who earned the Combat Infantryman Badge, Combat Action Badge, Combat Medical Badge or Combat Action Ribbon while assigned with the U.S. Army, U.S. Navy or U.S. Marine Corps may submit a copy of that award, along with other documentation required in this message, to the COMAFFOR for consideration for award of the AFCAM. The AFCAM may be awarded to members from the other U.S. armed forces and foreign soldiers serving in a U.S. Air Force unit, provided they meet the award criteria.