Application For License

I, [name of applicant], do hereby apply for a license to

display the trademark of [association], "[trademark] "

at my place of business located at [address], in

the City of [city], State of [state].
This application is in accordance with the

regulations of the [trade association].
I am cognizant of the regulations of [trade association]

that govern the display of said trademark and the manner

of conducting business, and I agree to abide by such

regulations at all times.
Dated:


_________________________________________