Trademark Licensing: Licensing Application

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Fields marked with an asterisk * are required.

Please complete and submit the online licensing application. A PDF application is also available; you may return it by fax or mail. If your application is approved, a Trademark License agreement will be sent to you.

COMPANY INFORMATION

* Company name as it will appear on the agreement:

Other names under which you do business (if this is a subsidiary, please give name & address of parent company):

Street Address:
City:	State:	Zip:
* Telephone #:	Fax #:
Web Address:

Is your company a
Corporation	Partnership	Proprietorship

State of Incorporation	Years in Business	Number of Employees

Do you have consolidated revenues of
$50 million or more	below $50 million	below $5 million

Applications must include the following required about your insurance carrier and levels of insurance.
* Name of Insurance Carrier:	* Address of Insurance Carrier:

* City:

* State:

* Zip:

Current level of product liability insurance (must be at least $1 million each):
Bodily Injury	* each occurence	* aggregate
Property Damage	* each occurence	* aggregate

Are you a:
	Small Business Enterprise (SBE), a business which is independently owned and operated with 100 or fewer full-time employees.
	Minority Business Enterprise (MBE), a business which is at least 51% owned and controlled by a minority(ies).
	Qualifying groups include: African American persons with origins in any of the black racial groups of Africa; Latino American persons of Spanish cultures with origins in Mexico, Central or South America, or the Caribbean Islands, regardless of race; Asian Pacific Islander persons with origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, Hawaii, or the Pacific Islands.
	Women Business Enterprise (WBE), a business which is at least 51% owned and controlled by a female(s).

Rutgers is a participating member of the Fair Labor Association, an antisweatshop initiative. We require all our licensees to also become affiliated with this organization.

Are you currently registered with the Fair Labor Association?	Yes	No	Date of Registration:
Have you completed the FLA application process?	Yes	No	Date of Application:

Are you an approved Follett licensed vendor?

Yes

Are you or is anyone else in your company an employee of Rutgers University?	Yes	No
If yes, who is the person in your company?	Self	Employee If employee name:
What is the relationship to the Rutgers employee?	Spouse Child Parent

Name of Employee:		Title:
Department:		Telephone #:		Email:

COMPANY INFORMATION

President

Name:
Address:
City:	State:	Zip:
Telephone #:	Fax:
Email:

Local Sales Representative

Name:
Address:
City:	State:	Zip:
Telephone #:	Fax:
Email:

Licensing Contact

Name:
Address:
City:	State:	Zip:
Telephone #:	Fax:
Email:

Artwork Approvals

Name:
Address:
City:	State:	Zip:
Telephone #:	Fax:
Email:

COMPANY INFORMATION

List all products you are requesting to have licensed:

Is your company the sole manufacturer of the finished product, including application of logos?

Yes

Does your company purchase blanks and then apply logos?

Yes

If yes, list source of all blank goods:

Do you manufacture the blanks and then have the logos applied elsewhere?

Yes

If yes, list company names and if logos are screen printed, embroidered, or other:

Are you currently licensed with any other colleges or universities? If so, please list the schools:

Do you use labels or hangtags on products?

Yes

SALES/DISTRIBUTION INFORMATION

Will your company be producing merchandise for:

resale only

internal use only

both

Are you an advertising specialty company?

Yes

Are you a member of ASI?

Yes

Does your company sell signs or displays for internal use only?

Yes

If these products are for resale, where will they be sold?

List the areas of distribution of Rutgers' finished products.
National:
Regional (list regions):
Local (list areas):

List departments and organizations you have worked with previously or expect to work with (include contact person):

Do you currently have an order to produce Rutgers merchandise?

Yes

If yes, please specify from whom: