Boy Scout Religious Emblem Application Submission & Payment

- Application Submission/Payment for Ad Altare Dei & Pope Pius XII Religious Emblems
  
  Congratulations on completing your religious emblem! Please proceed through Steps One-Three to complete the process of earning your Emblem and to receive your Awards Packet at the Religious Emblems Mass (Religious Emblem/Medal, plus the Religious Knot, Parent Pin and Pocket Certificate).
  
  Step One - Upload Completed Emblem Application Documents with Signatures (Pages from Activity Booklet)
  Step Two - Online Application and Payment ($40)
  Step Three - Sign Up for a Board of Review
  
  Applications are due by November 1, 2025 for Scouts who would like to be recognized at the January 2026 Religious Emblems Mass. More information about how to sign up for a Board of Review will be available in Fall 2025.
  
  Questions? Contact Jerry De Santos at [email protected].
  
  STEP ONE - Upload Completed Emblem Application Documents
  
  Please CLICK HERE to upload a copy (PDF or JPG/PNG Image) of the following applicable forms found at the back of the relevant Religious Emblem Youth Manuel:
  
  For Ad Altare Dei:
  “Application to Begin Working on the Ad Altare Dei Emblem”
  “Application for Review and Presentation – Ad Altare Dei Emblem”
  
  For Pope Pius XII
  “Application to Begin Working on the Pope Pius XII Emblem”
  “Application for Review and Presentation – Pope Pius XII Dei Emblem”
  
  All approvals and signatures should show as being obtained. If you have any difficulty uploading, the copies can be e-mailed to Jerry DeSantos at [email protected] or you can bring the copies to your Board of Review. Please contact Jerry if you have any questions as well.
  
  An online application is not considered complete until the above mentioned application documents are submitted and approved. After uploading the form, return to this page to proceed to Step Two.
  
  STEP TWO - Online Application and Payment
  
  Scouts who have completed the Ad Altare Dei or Pope Pius XII Emblem Program with a certified counselor/facilitator should submit the form below to the Diocese of Orange Catholic Committee on Scouting (DCCS) to complete the process of earning the Emblem and to sign up for a Board of Review (scheduled for Saturday, Nov. 9, 2024 - Step 3: Board of Review Sign up details will be provided in your confirmation e-mail). (Multiple submissions for the same emblem can be processed at one time.).
  
  Payment Options - Payment can be made online via Credit Card or ACH Debit or by Check or Cash (Choose "Pay Later" below). (NOTE: If you are paying by check or cash, please bring the payment to your Board of Review; payment be credit card can also be made at the Board of Review.). Fee is $40 per application for the award packet. Please make checks payable to "DCCS." Note Scout/Unit on check memo line.)
- Application/Payment Form
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  NOTE: Multiple submissions for the same emblem can be processed at one time.
  
  Religious Emblem Completed REQUIRED Please fill out this field.
  
  How many Scouts are you submitting for? REQUIRED Please fill out this field.
  
  Scout 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Scout 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phonetic Spelling of Scout’s Name: (To assist readers at the Religious Emblems Mass; Ex.: Raul Gonzalez: rah-OOL gon-SAH-les) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  Scout Phone # Maximum 20 characters Please enter a phone number.
  
  Scout Email Please enter an email address.
  
  Parent/Guardian Phone # REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
  
  Unit REQUIRED Please fill out this field.
  
  Unit # REQUIRED Please fill out this field. Please enter valid data.
  
  Parish/City Scout Attends REQUIRED Please fill out this field. Please enter valid data.
  
  If this Scout has completed all four religious emblems - Light of Christ, Parvuli Dei, Ad Altare Dei (or Light is Life Emblem for Eastern Rite Catholic Scouts), and Pope Pius XlI - he/she is eligible to receive the Pillars of Faith Pin. Yes, this Scout has earned all four religious emblems. No. I don't know.
  
  Counselor/Facilitator REQUIRED Please fill out this field. Please enter valid data.
  
  Counselor/Facilitator Phone # Please enter valid data.
  
  Counselor/Facilitator Email REQUIRED Please fill out this field. Please enter valid data.
  
  Religious Emblem Award Packet40.0
  
  Person Submitting Form REQUIRED Please fill out this field. Please enter valid data.
  
  Phone # of Person Submitting Form REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email of Person Submitting Form REQUIRED Please fill out this field. Please enter an email address.
  
  Comments
  
  By checking the box below and submitting this form, I hereby make application for the above-stated Religious Emblem(s) and agree to the payment total listed. On my honor as a Scout and a Catholic, I hereby certify that I have faithfully fulfilled all the requirements for this emblem. I further certify that I have obtained required approvals before beginning the program, my counselor’s certification upon completion, and have prepared myself as best I can for review. I further certify that I have obtained required approvals.
  
  I Agree Please select this field.
  
  Processing Fee REQUIRED Yes I will cover the 3% fee to support the DCCS No, not at this time Please fill out this field.
  
  Total:
  
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