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Department or Student Organization Making Request
Contact Information of Individual Making the Request
First Name
Last Name
Phone
Email Address
Name of Licensed Company
Company Contact Information
First Name
Last Name
Phone
Email Address
Product(s) Ordering
Quantity of Product
Product will be: (check all that apply)
Given away at an event (there is a registration fee for the event)
Given away at an event (there is NOT a registration fee for the event)
Given to staff or students as a uniform
Sold to alumni, fans, campers, attendees, or others
Sold as a fundraiser
Used as team apparel or uniform
Other (describe in additional information field)
If "other" please describe what the product will be used for.
Name and Date of Event
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