The Empire Of Ironthorn College of Heralds * Device or Badge Submission Form Please send device or badge submissions to The Empire Herald,please remit payment in the form of check or money order. Payable to The Empire of Ironthorn College of Heralds. Submission fee $3.00 --------------------------------------------------------------------------------
Society Name: ---------------------------------------------- Legal Name: ---------------------------------------------- Address: ---------------------------------------------- Phone Number: E-Mail -------------------- -------------------- Date Submitted: Date of Birth: -------------------- ------------ Consulting Herald: Herald's Phone/email: ------------------ --------------------- If you previously submitted to a Empire/Kingdom which one? ---------------------------------------------------------------------
Action Type:Check appropriate box O New submission O Change O Re-submission O Appeal O other/specify ------------------ Important Factors: If the College of Heralds feels a need to suggest possible changes to you, what elements of the device or badge do you most want to keep? O Charge(s) O Colors O Other/specify --------------------------------- -------------------------------------------------------------------------------- Purpose Blazon: Give the Blazon of your desire, consult a Herald if possible. If you dont know how to Blazon, give a clear description in english. ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- I understand by my submission, I automatically give my permission for The Empire of Ironthorn to use my artwork, device, or badge for any and all internal heraldic and scholarly purposes. Signature Date -------------------------------------- ---------------------------- Approved by: Date ----------------------------------- ---------------------------- Rejected by: Date ----------------------------------- ----------------------------
