Application Form for Category C Licensees

Please complete the Licensee Online Application to become affiliated with the Fair Labor Association (for category definitions, click here). Please make sure that you have completed all sections of the application. Incomplete applications can not be processed for approval. You will receive an automatic confirmation notice that indicates receipt of your submission.

* indicates required field

Company name: *
Contact name: *
Contact title: *
Address 1: *
Address 2:
City: *
State or Province: *
Zip / Postal code: *
Country *
Phone: *
Fax:
Email: *
Company website:

Please describe the primary focus of your business.
If your company does not have a direct relationship with the manufacturer, please describe how the product is procured. (For example, blank products are bought through a distributor/broker.)
Company Total Annual Revenues*

What kind of licensed goods does your company produce? *

Does your company participate in any factory compliance programs?
	Yes No
* I have read and agree with the following: Our company fits the requirements for a Category C licensee with the Fair Labor Association. Our Company�s total annual revenues are between $5 million and $50 million (or, if under $5 million, my Company buys products from a factory(ies) overseas). In addition, our company agrees to the requirements for a Category C licensee as written in the FLA�s Charter. View the Charter document.