Request for Licensing Agreement

Please fill out this form to request use of IBHS’s trademarks. Someone will reach out to you about this request within two weeks. Submission of this request does not constitute a licensing agreement. IBHS retains the exclusive right to approve or deny any request to use its trademarks.

Name(Required)

First Last

Today's Date(Required)

Name of Company(Required)

Company Website(Required)

Address of Company(Required)

Street Address Address Line 2 City State ZIP Code

Name of Contact Person(Required)

First Last

Email Address of Contact Person(Required)

Phone Number of Contact Person

Business Type(Required)

Corporation

LLC

Partnership

Sole Proprietorship

Nonprofit Organization

Trademark License Desired(Required)

FORTIFIED

Wildfire Prepared Home

IBHS

Briefly Describe How the Trademark Will Be Used (i.e. educational programming, marketing a product, etc.)(Required)

Name and Description of Product that Will Be Associated with Trademark(Required)

Can Product be used as part of meeting the FORTIFID or Wildfire Prepared Home technical standard(s)? If so, please describe.

Does your company have an affiliation with IBHS (i.e. IBHS member, MOU, MOA)?(Required)

Desired Licensing Period

Less than 1 year

1-3 years