NIL Use Request Form

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I am a *

Organization Student-Athlete

Email address *

First name *

Last name *

Address 1 *

City *

State *

ZIP Code *

Name of student athlete *

Sport of Student athlete *

What are you requesting to use? *

Logo Verbiage or name Photo or imagery

Please describe the requested item(s) *

The requested logo, verbiage, or imagery will be used on which of the following? *

Product Printed Material Web Page or Social Media Other

Please describe the intended use(s) *

Will a corporate logo/name be associated with the College's name, logo, imagery, or indicia? *

Yes No

* required field