Trademark Use Request
Please complete this form if you would like permission to use the name or seal of the
Eastern Shawnee Tribe of Oklahoma. Requests will be reviewed by the Business Committee
within thirty (30) days of receipt. Please provide as much detail as possible before submitting
your request.
Requestor Information: _________________________________________
Name: ______________________________________________________
Roll Number: ________________________________________________
Address: ____________________________________________________
Telephone Number: ___________________________________________
Email: ______________________________________________________
Use Information:
What mark(s) are you seeking permission to use?
____________________________________________________________
What is the intended use of the mark(s)?
____________________________________________________________
Who is your intended audience?
____________________________________________________________
What is the intended duration of use?
____________________________________________________________
Additional information:
____________________________________________________________
____________________________________________________________
Date: ___________________________________
Signature: _______________________________
Please return completed form and all supporting documents to Chad Kelly,
BC Liaison at ckelly@estoo.net
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signature
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