Licensing Authorization Form
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Month
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Day
Year
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Contact Information
Requester Name
*
First Name
Last Name
Requester E-mail
*
example@email.campbell.edu
Requester Phone Number
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Area Code
Phone Number
Organization/Department Name
*
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Product Information
Product will be:
*
Given Away/Promotional Purposes
Used as a Fundraiser
Internal Use (ie Club/Department Member T-Shirts)
Other
If Other, Please explain.
Describe the Type of Product (T-shirts, mugs, notepads)
*
Item Description -- QTY (if known)
Cost Per Unit/Estimated Total Cost ($5/50) (If known)
Is this product using Campbell Athletic marks?
Yes
No
Is this product to be funded by a grant?
Yes
No
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Supplier
Supplier Company Name (Must be a Licensed Vendor)
*
Supplier Email
*
Supplier Contact Number
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Area Code
Phone Number
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Artwork
Please upload a file(s) of your proposed use of Campbell trademarks and your layout. For apparel, please include front and back designs.
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Additional Files
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Additional Comments or Questions for licensing office
Request Submission
I verify that the above organization is a valid campus department or registered student organization and that the fundraising/promotional project described above is only for the purpose of supporting the organization, not for the profit of an individual or business. (use computer mouse or finger to sign).
Submit Order
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