Sponsor/Vendor/Supplier Request (Please complete the following information.)

1. Name of Company or Organization

2. Your Name

3. Street or Mailing Address

4. City

5. Province / State

6. Postal Code / ZIP Code

7. Telephone Number

8. Email Address

9. Which trademark(s) do you propose to use and how will it be used?

10. When is the trademark to be used?

11. If the trademark is to be used for media purposes (banners, advertising, etc.), how long will the trademark be used?

12. Comments or additional information to assist with your request.