Licensing Authorization Form
Date Picker Icon
Requester Phone Number
Official Student Organization
Arts & Sciences
Pharmacy & Health Sciences
Student Life Coordinator Name (Registered Student Groups Only)
Student Life Coordinator E-mail (Registered Student Groups Only)
Will this product include the names, marks or representations of Campbell University? (running camel, kivett symbol, logos, etc)
Product will be:
Given Away/Promotional Purposes
Used as a Fundraiser
Internal Use (ie Club/Department Member T-Shirts)
If Other, Please explain.
Describe the Type of Product (T-shirts, mugs, notepads)
Item Description -- QTY
Cost Per Unit/Estimated Total Cost ($5/50)
Supplier Company Name (Must be a Licensed Vendor)
Supplier Contact Number
Please upload a file(s) of your proposed use of Campbell trademarks and your layout. For apparel, please include front and back designs.
Additional Comments or Questions for licensing office
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).
Should be Empty: