The Maltese cross, in Italy also known as the Amalfi cross, is the cross symbol associated with the Knights Hospitaller (the Knights of Malta) and by extension with the island of Malta. The cross is eight-pointed and has the form of four "V"-shaped elements, each joining the others at its vertex, leaving the other two tips spread outward symmetrically. Its design is based on crosses used since the First Crusade. It is also the modern symbol of Amalfi, a small Italian republic of the 11th century.