achcrossettemb.jpgPRINTABLE APPLICATION FORM

(Use this form to quickly complete all necessary information, then print out and mail - or scan and e-mail - with payment - PLEASE NOTE THAT SOME TEXT BOXES MAY NOT BE LARGE ENOUGH TO COMPLETELY DISPLAY THE INFORMATION YOU ENTER - PLEASE REVIEW YOUR APPLICATION THOROUGHLY TO ENSURE ALL INFORMATION IS DISPLAYED COMPLETELY AND CORRECTLY)

 

The American College of Heraldry

1818 North Taylor St, Suite B #312, Little Rock, AR 72207

A Non-profit Corporation Established 1972

EMAIL info@americancollegeofheraldry.org

 

I am applying for:

 

PLEASE FILL OUT ALL ITEMS COMPLETELY

If you are only applying for annual membership, you do not need to fill out the complete form, only Section I

SECTION I

 

Title(s):

Name: (First, Middle, Last):

Street Address:

City:

State:   County (not Country):    Zip/Postal:

Country:

Telephone:  E-mail:


SECTION II

 

I am requesting the College to:

Design a new coat of arms for my personal use and to Register and Publish the same.

Register and Publish the coat of arms I now have which has notyet been granted, registered,

      certified, or otherwise recognized for my personal use by a domestic or foreign office of arms.

Register and Publish the coat of arms I now have which were:

        

         * I am enclosing information verifying this armorial recognition.

I am not requesting a Registration of Arms at this time.

 

The Armiger's News will be sent to members in PDF format

on or about the 1st of January, April, July, and October


STOP HERE IF YOU ARE ONLY APPLYING FOR ANNUAL MEMBERSHIP

SCROLL DOWN TO COMPLETE PAYMENT INFORMATION AND PRINT THIS FORM

Date of Birth:

City, County and State of Birth:

Marital Status: Married Never Married Widowed Divorced Other

Sex: Male Female


Full MAIDEN name of your Spouse: (First, Middle, Last):

   

Children born to or adopted by you and the above named spouse:

 

 

 

 

 

 

NOTE: Should you have any children whatsoever by previous marriages, it is VITAL that you enclose full information on both children and their mother(s) as noted in the last question. Further, if this registration is for someone who is a grandfather, then include all eligible descendants (attach a separate page if necessary), such as all children of the armiger, as well as all of the children of those children. Please be sure to include MAIDEN names of any spouses as parents of additional children.

By completing this application for a registration of armorial bearings, I hereby consent to the publication of my name, place of birth, and place of residence in the College's journal, The Armigers News, which is distributed in electronic form.

Signature _________________________________________    Date ________________________________

Please print out and mail, or scan and e-mail this completed application, along with any additional documentation, and applicable funds as indicated in the above section on fees.

 

PLEASE NOTE THAT SOME TEXT BOXES MAY NOT BE LARGE ENOUGH TO COMPLETELY DISPLAY THE INFORMATION YOU ENTER - PLEASE REVIEW YOUR APPLICATION THOROUGHLY TO ENSURE ALL INFORMATION IS DISPLAYED COMPLETELY AND CORRECTLY

METHOD OF PAYMENT:

Check or Money Order made payable to THE AMERICAN COLLEGE OF HERALDRY

Visa   MasterCard   American Express   Discover  *

 

  Card # ___________ - ___________ - ___________ - ___________   Exp Date ___________   CID ___________

 

 Your signature above indicates acceptance of credit card charges.

 

* IF YOU WISH TO BE BILLED BY PAYPAL, PLEASE INCLUDE YOUR PAYPAL EMAIL ADDRESS HERE:

     

 

IMPORTANT- CHECK THIS BOX IF YOU HAVE PAID ONLINE, RATHER THAN INCLUDING PAYMENT HERE

MAIL THIS APPLICATION TO:

  The American College of Heraldry

  1818 North Taylor St, Ste B #312

  Little Rock, AR 72207  USA

SCAN & E-MAIL THIS APPLICATION TO:

  dwooten@americancollegeofheraldry.org

 

Copyright 1990-2015 The American College of Heraldry

** Credit card billing offered as a gratis service to The American College of Heraldry by Gryfons Publishers.

Credit card statements will reflect charges from GRYFONS PUBLISHERS