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                , State of                .

That 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:_______________       ______________________________
                                      [Signature]