Licensing Authorization Form
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Month
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Day
Year
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Contact Information
Requester Name
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First Name
Last Name
Requester E-mail
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example@email.campbell.edu
Requester Phone Number
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Area Code
Phone Number
Organization
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Official Student Organization
Club Sport
Organization Name
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School/College
Arts & Sciences
Business
Divinity
Education
Engineering
Law
Medicine
Pharmacy & Health Sciences
Student Life Coordinator Name (Registered Student Groups Only)
First Name
Last Name
Student Life Coordinator E-mail (Registered Student Groups Only)
*
example@campbell.edu
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Product Information
Will this product include the names, marks or representations of Campbell University? ("Campbell", "Campbell University" running camel, Kivett symbol, logos, etc)
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Yes
No
Product will be:
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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)
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Item Description -- QTY
Cost Per Unit/Estimated Total Cost ($5/50)
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Supplier
Supplier Company Name (Must be a Licensed Vendor)
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Supplier Email
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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
Browse 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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