Fill out the form below to apply for an alternative emblem of belief for your headstone.

"*" indicates required fields

Name*
Deceased's Name*
Please tell us why the belief is represented by this emblem or symbol and that it constitutes a religion or the functional equivalent of a religion, and that it was sincerely believed and/or accepted as true by the deceased during his/her/their life.
Submit a 3-inch diameter illustration of the design for which approval is requested
Max. file size: 5 MB.