Partnerships: Become a Licensee

Partnerships: Become a Licensee

Legal Company Name*

Please enter your Company's full business name

Owner/Parent Company*

Other Business Names Used*

List any other names under which you or principals of the company do business(dba's/aka's/etc)

Type of Business Organization*

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Address #1*

Address #2

City*

Zip Code*

State*

Phone Number*

Company Email Address*

Company Website URL*

Company Contact Info - Principal Licensing Contact*

Company Contact Email Address*

Company Contact Phone Number*

Product Types*

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Other Business Information

Please submit any other information about your business that you feel is necessary.

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