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{\listoverride\listid-131\listoverridecount0\ls269}{\listoverride\listid-132\listoverridecount0\ls270}}{\info{\title Society Name}{\author x}{\operator x}{\creatim\yr2006\mo4\dy5\hr22\min2}{\revtim\yr2008\mo6\dy29\hr21\min20}
{\printim\yr2004\mo3\dy1\hr23\min2}{\version10}{\edmins47}{\nofpages1}{\nofwords395}{\nofchars1900}{\*\company x}{\nofcharsws0}{\vern71}}\margl720\margr720\margt418\margb662 
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{\header \pard\plain \s15\nowidctlpar\widctlpar\tqc\tx5670\tqr\tx10890\adjustright \f1\fs28\lang2057\cgrid {\b\fs24 Atenveldt}{\b \tab }{\b\fs32 \tab }{\b\fs24 Name Submission Form}{\b\fs32 
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\par }\pard\plain \sa60\nowidctlpar\widctlpar\adjustright \f1\fs20\lang2057\cgrid {\fs16 Instructions: Give three copies to your local herald.  Make checks / money orders payable to payable to your local branch or "Kingdom of Atenveldt, SCA, Inc.".}{
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\qr\sb60\nowidctlpar\widctlpar\intbl\adjustright {\cs19\fs18 Laurel\cell }\pard \sb60\nowidctlpar\widctlpar\intbl\adjustright {\cs19\fs28 \cell }{\cs19\fs16 \cell }{\cs19\fs28 \cell \cell }\pard \nowidctlpar\widctlpar\intbl\adjustright {\row }\pard\plain 
\s16\sb60\nowidctlpar\widctlpar\tqc\tx5103\tqr\tx10490\adjustright \f1\fs14\lang2057\cgrid {\tab \tab  Laurel v. 2.0; Atenveldt v2.1 (Laurel Approved [26 Jun 2008])
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\par }\pard \li144\nowidctlpar\widctlpar\tx360\adjustright {\fs18 \tab Other (specify)   
\par }\pard \li144\nowidctlpar\widctlpar\adjustright {\cs19\fs18 ______________}{\fs18 
\par }}\dpx8719\dpy8\dpxsize2205\dpysize2946\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinehollow}}}
{\shp{\*\shpinst\shpleft8851\shptop229\shpright9038\shpbottom416\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz22\shplid1029{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8214\dprect\dpx8851\dpy229\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{Legal name\tab  
\par }\pard \s18\sb120\nowidctlpar\widctlpar\tqr\tx1620\tldot\tx7088\adjustright {\lang1024 {\shp{\*\shpinst\shpleft9076\shptop316\shpright9263\shpbottom503\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz16\shplid1030
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8208\dprect\dpx9076\dpy316\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft7111\shptop151\shpright7298\shpbottom338\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz23\shplid1031{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8215\dprect\dpx7111\dpy151\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft8851\shptop106\shpright9038\shpbottom293\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz21\shplid1032{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8213\dprect\dpx8851\dpy106\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{Address  }{\fs16 (complete)\tab }{\tab \tab 
\par }\pard \s18\sb60\nowidctlpar\widctlpar\tx180\tqr\tx1620\tldot\tx7088\adjustright {\fs16 \tab }{\cs19\fs16 (incl}{\cs19 .}{\cs19\fs16  city, state, zip)\tab }{\cs19 \tab }{\cs19\fs16 
\par }\pard\plain \s20\sb60\nowidctlpar\widctlpar\tldot\tx3969\tx6120\tx6210\tx6480\tx6750\tldot\tx7088\tldot\tx10490\adjustright \f1\fs20\lang2057\cgrid {\lang1024 
{\shp{\*\shpinst\shpleft6496\shptop64\shpright6683\shpbottom251\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz13\shplid1033{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8205\dprect\dpx6496\dpy64\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft5956\shptop64\shpright6143\shpbottom251\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz12\shplid1034{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8204\dprect\dpx5956\dpy64\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft8851\shptop85\shpright9038\shpbottom272\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz20\shplid1035{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8212\dprect\dpx8851\dpy85\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{Branch Name\tab Gender of Submitter\tab }{\cs19 \tab }{M\tab }{\cs19 \tab }{F
\par }\pard \s20\sb60\nowidctlpar\widctlpar\tldot\tx3969\tldot\tx7088\adjustright {\lang1024 {\shp{\*\shpinst\shpleft9076\shptop7\shpright9263\shpbottom194\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz15\shplid1036
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8207\dprect\dpx9076\dpy7\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft9076\shptop202\shpright9263\shpbottom389\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz14\shplid1037{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8206\dprect\dpx9076\dpy202\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{Phone Number\tab Date of Birth\tab 
\par }{\lang1024 {\shp{\*\shpinst\shpleft8851\shptop124\shpright9038\shpbottom311\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz19\shplid1038{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8211\dprect\dpx8851\dpy124\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{E-mail Address\tab Date Submitted\tab \tab \tab }{\cs19\fs18 
\par }\pard\plain \s29\sb60\nowidctlpar\widctlpar\tldot\tx3969\tldot\tx8789\adjustright \f1\fs20\lang2057\cgrid {\lang1024 
{\shp{\*\shpinst\shpleft8851\shptop261\shpright9038\shpbottom448\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz17\shplid1039{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8209\dprect\dpx8851\dpy261\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{Consulting Herald\tab Herald's E-mail/Phone\tab 
\par }\pard\plain \s25\sb60\nowidctlpar\widctlpar\tx270\tldot\tx2835\tldot\tx8730\tldot\tx8789\adjustright \f1\fs20\lang2057\cgrid {\cs19\b\fs18 ++}{\cs19\fs16  \tab Name(s) previously submitted 
\par }\pard \s25\li270\nowidctlpar\widctlpar\tldot\tx8730\tldot\tx8789\adjustright {\lang1024 {\shp{\*\shpinst\shpleft8851\shptop105\shpright9038\shpbottom292\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz18\shplid1040
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8210\dprect\dpx8851\dpy105\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs16 but not registered (if any)}{\tab 
\par }\pard \s25\sb60\nowidctlpar\widctlpar\tx270\tldot\tx5670\tldot\tx8789\adjustright {\cs19\b\fs18 ++}{\cs19\fs18 \tab Kingdom submitted from: }{\tab }{\b ++}{\cs19\fs18 Date returned:}{ \tab }{\cs19\fs18 
\par }\pard\plain \sb60\nowidctlpar\widctlpar\brdrt\brdrdb\brdrw15\brsp20 \adjustright \f1\fs20\lang2057\cgrid {\cs19\fs18 Name processing criteria.}{ }{\cs19\fs18\ul Read these carefully}{\cs19\fs18 
. Laurel may need to make changes in order to register the name.
\par }\pard\plain \s33\fi180\sb60\nowidctlpar\widctlpar\brdrt\brdrdb\brdrw15\brsp20 \adjustright \f1\fs20\lang2057\cgrid {\cs19\b\fs18 MAJOR}{\cs19\fs18  changes include: }{\fs18 adding/dropping a name element, changing an element\rquote 
s language, changing the order of elements}{\cs19\fs18 .
\par }\pard\plain \fi180\nowidctlpar\widctlpar\brdrt\brdrdb\brdrw15\brsp20 \adjustright \f1\fs20\lang2057\cgrid {\cs19\b\fs18 MINOR}{\cs19\fs18  changes include: }{\fs18 
accents, punctuation, hyphenation, addition or deletion of a letter, upper-lower case changes, etc}{\cs19\fs18 ..}{
\par }\pard \fi-270\li270\sb60\nowidctlpar\widctlpar\brdrt\brdrdb\brdrw15\brsp20 \tx270\adjustright {\lang1024 {\shp{\*\shpinst\shpleft-14\shptop83\shpright173\shpbottom270\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz4\shplid1041
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8196\dprect\dpx-14\dpy83\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 \tab }{\cs19\b\fs18 I will NOT accept MAJOR changes to my name}{\cs19\fs18 
, even if the name cannot be registered without such changes.}{
\par }\pard\plain \s26\fi-270\li270\sb60\nowidctlpar\widctlpar\tx270\adjustright \f1\fs20\lang2057\cgrid {\lang1024 {\shp{\*\shpinst\shpleft-14\shptop83\shpright173\shpbottom270\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz3\shplid1042
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8195\dprect\dpx-14\dpy83\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 \tab }{\cs19\b\fs18 I will NOT accept MAJOR or MINOR changes to my name}{\cs19\fs18 
, even if the name cannot be registered without such changes.
\par Note: Leaving both boxes blank indicates that you will accept both major and minor changes in order to register your name.
\par }\pard\plain \s27\sb60\nowidctlpar\widctlpar\brdrt\brdrs\brdrw15\brsp20 \tx4500\tx4770\tx5850\tx6120\tx7020\tx7290\tx8280\tx8505\adjustright \f1\fs20\lang2057\cgrid {\lang1024 
{\shp{\*\shpinst\shpleft8236\shptop98\shpright8423\shpbottom285\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz6\shplid1043{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8198\dprect\dpx8236\dpy98\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft5851\shptop98\shpright6038\shpbottom285\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz5\shplid1044{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8197\dprect\dpx5851\dpy98\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft7021\shptop98\shpright7208\shpbottom285\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz25\shplid1045{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8217\dprect\dpx7021\dpy98\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft4501\shptop98\shpright4688\shpbottom285\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid1046{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8193\dprect\dpx4501\dpy98\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 If my name must be changed, I care most about:\tab \tab meaning\tab \tab sound\tab \tab spelling\tab 
\tab language and/or culture}{
\par }\pard\plain \s22\sb60\nowidctlpar\widctlpar\tldot\tx10620\adjustright \f1\fs18\lang2057\cgrid {\cs19\fs16 (Please specify "meaning", "sound", \ldblquote spelling\rdblquote  or "language and/or culture" desired)\tab }{\fs16 
\par }\pard\plain \s27\sb60\nowidctlpar\widctlpar\brdrt\brdrs\brdrw15\brsp20 \brdrb\brdrs\brdrw15\brsp20 \tx5850\tx6120\tx7020\tx7290\tx8280\tx8505\adjustright \f1\fs20\lang2057\cgrid {\lang1024 
{\shp{\*\shpinst\shpleft8236\shptop91\shpright8423\shpbottom278\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz8\shplid1047{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8200\dprect\dpx8236\dpy91\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft5851\shptop91\shpright6038\shpbottom278\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz9\shplid1048{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8201\dprect\dpx5851\dpy91\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}
{\shp{\*\shpinst\shpleft7021\shptop91\shpright7208\shpbottom278\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz7\shplid1049{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8199\dprect\dpx7021\dpy91\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 The desired gender of my name is:\tab \tab male\tab \tab female\tab \tab don't care
\par }\pard \s27\sb60\nowidctlpar\widctlpar\tldot\tx10440\adjustright {\cs19\b\fs18 [OPTIONAL]}{\cs19\fs18  Please }{\cs19\b\fs18 CHANGE}{\cs19\fs18  my name to be authentic for:}{\cs23\fs22 \tab }{
\par }\pard \s27\sb60\nowidctlpar\widctlpar\tx7020\tx7290\tx8505\adjustright {\lang1024 {\shp{\*\shpinst\shpleft8236\shptop69\shpright8423\shpbottom256\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz10\shplid1050
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8202\dprect\dpx8236\dpy69\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 Please be specific, e.g. '12th-14th century' or 'Irish' or \lquote Welsh\rquote 
, rather than saying 'early' or\tab \tab language and/or culture
\par }\pard \s27\nowidctlpar\widctlpar\tx5103\tx6804\tx7020\tx7290\tx8510\adjustright {\lang1024 {\shp{\*\shpinst\shpleft8236\shptop0\shpright8423\shpbottom187\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz26\shplid1051
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8218\dprect\dpx8236\dpy0\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 'late' or 'Celtic'.  Please }{\fs18 do not select this option if you do not wish changes to your name
}{\cs19\fs18 .\tab \tab time period}{
\par }\pard\plain \sb60\nowidctlpar\widctlpar\brdrt\brdrs\brdrw15\brsp20 \adjustright \f1\fs20\lang2057\cgrid {If you are, or will soon be, submitting another item (such as a device, badge, or household name):
\par }\pard\plain \s22\sb60\nowidctlpar\widctlpar\adjustright \f1\fs18\lang2057\cgrid {\cs19 
If the Laurel Sovereign of Arms finds that your name cannot be registered for any reason, and you do not already have a name previously registered, Laurel may create a "holding name
" for you so that your other item can be registered. This holding name will be treated as your registered name until you register an acceptable name. There is no fee for changing a holding name.
\par }\pard\plain \s26\fi-360\li360\sb60\nowidctlpar\widctlpar\tx360\adjustright \f1\fs20\lang2057\cgrid {\lang1024 {\shp{\*\shpinst\shpleft-14\shptop89\shpright173\shpbottom276\shpfhdr0\shpbxcolumn\shpbypara\shpwr3\shpwrk0\shpfblwtxt0\shpz11\shplid1052
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fShadow}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8203\dprect\dpx-14\dpy89\dpxsize187\dpysize187
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\cs19\fs18 \tab I will }{\cs19\b\fs18 NOT}{\cs19\fs18  allow the creation of a holding name. I understa
nd that if my name submission is returned, then my other submission(s) will be returned as well.
\par }\pard\plain \sb60\nowidctlpar\widctlpar\brdrt\brdrdb\brdrw15\brsp20 \adjustright \f1\fs20\lang2057\cgrid {Name Documentation and Consultation Notes (attach additional sheets and documentation as needed.)\sect }\sectd 
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