COLLEGE AND UNIVERSITIES LICENSE REQUEST FORM

Before completing this request, please read this form in its entirety and ensure that all questions are answered completely and accurately.

NOTE: The Office of the General Counsel and Compliance ("OGCC") will not review incomplete submissions. If your submission is deemed incomplete, OGCC will notify you via the email you provide below.

We will process completed submissions within at least two (2) weeks of receipt.

Please review Delta's Brand Style Guide to ensure that your design adheres to Delta's brand messaging standards:

https://www.dropbox.com/s/o7gan33uej7y78w/FINAL%20Brand%20Style%20Guide.pdf?dl=0

By submitting this form, you also acknowledge that your college or university has an active Delta Chapter. Please confirm with your respective chapter its status before filing the request.

If you have any further questions concerning this process, please contact OGCC at legal@deltasigmatheta.org.
LICENSING REQUEST FORM

Colleges & Universities
Name of Requestor:*

PrefixFirst NameLast Name
Email of Requestor:*
example@example.com
Is the requestor the authorized signatory?*

YesNo
If "yes", enter additional contact information.*
Title, phone number, and street address
If "no", enter authorized signatory name, title, and contact information.*
Title, phone number, and street address
Delta Chapter Information:*
Chapter name, College & University, Chapter Advisor/Representative name and email
Is the Delta chapter active?*

YesNo
College/ University Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Chapter's Point of Contact (POC):*
Name, title, phone number, and email
What type of tax entity does the University operate as?*
i.e., 501(c)(7), etc.
LICENSE INFORMATION
Check off the mark(s) you would like permission to use:*

Enhanced CrestDelta Sigma Theta Sorority, Incorporated™Delta Sigma Theta Sorority, Inc.®Greek Letters "ΔΣΘ®"Fortitude SymbolFounding Date and LocationCharter Date and LocationMottoOther
What other Delta trademarks and inscriptions do you intend to use? (Delta requires the word "chartered" to be used in reference to the chapter's charter date, while "founded" is used with our national founding date) *
Include specific details about the purpose of your use.
What is the purpose & location of trademark use on the intended display? *
Indicate manner (e.g., Greek letters on concrete pillar), location, and time length of use.
Aside from the above, what materials will display Delta marks and how?*
Material examples include fabric, concrete/brick, glass, and paper/cardboard.
Please upload image files & other design specifications. (e.g., final shop drawings, location schematics/plans, inscription documents, etc.) *

Browse Files
Acceptable formats include .PDF, .JPG, or .PNG Cancelof
Check off the color(s) and format(s) of the mark(s) you would like to receive:*

ColorBlack & Whitejpg (Ideal for web pages & electronic materials)eps ( Ideal for printed material)pdf
Intended Start Date:*

MonthDayYear
Date
Intended End Date:*

MonthDayYear
Date
Intended Public Unveiling Date:*

MonthDayYear
Date
Will the University use a third party vendor/independent contractor to construct the project? (If yes, please respond to the following question)*

YesNo
If "yes", please provide the company contact information*
Business name, title, phone number, email, and street address
Should be Empty:

LICENSING REQUEST FORM

LICENSE INFORMATION