Branch Name	
+ 	Name being submitted
	(if different from above)	

Name Type (pick one)
	Primary
	Order/Award +
	Guild / Household +
	Other (specify) +

_____________

Action Type
	New
	Resubmission ++
		Kingdom
		Laurel	
	Change+
	(if registered, old name will be released)
	Appeal (attach justification)                     
	Other (specify)   
______________

Legal Name of Contact	 
Address		
	
Phone Number	Date Submitted	
E-mail Address	
Consulting Herald	Herald's E-mail / Phone	
++ 	Name(s) previously submitted 
but not registered (if any)	
++	Kingdom submitted from: 	++Date returned: 	
Note: Group Names and Devices must be accompanied by a petition showing the support of the populace.  It must identify the name and/or device being submitted.  It must be signed by the Seneschal and either three-fourths of the officers or a majority of the populace.  Consult with Beacon Herald if you have questions about the procedure.
Name processing criteria. Read these carefully. Laurel may need to make changes in order to register the name.
MAJOR changes include: adding/dropping a name element, changing an element’s language, changing the order of elements.
MINOR changes include: accents, punctuation, hyphenation, addition or deletion of a letter, upper-lower case changes, etc..
	We will NOT accept MAJOR changes to our name, even if the name cannot be registered without such changes.
	We will NOT accept MAJOR or MINOR changes to our name, even if the name cannot be registered without such changes.
Note: Leaving these checkboxes blank indicates that you will accept both major and minor changes in order to register your name.
If our name must be changed, we care most about:		meaning		sound		spelling		language and/or culture
(Please specify "meaning", "sound", or "language and/or culture" desired)	
[OPTIONAL] Please CHANGE our name to be authentic for:	
Please be specific, e.g. '12th-14th century' or 'Irish' or ‘Welsh’, rather than saying 'early' or		language and/or culture
'late' or 'Celtic'.  Please do not select this option if you do not wish changes to your name.		time period
Name Documentation and Consultation Notes (attach additional sheets and documentation as needed.)