Manufacturing Authorization Application
Application Type:  

Company Information
Company Name:  
Business Type:  
Phone:   Fax:   Email:  
Company Address:  
City:   State:   Zipcode:  
Company Website:  

Primary Contact
Name:   Title:  
Phone:   Fax:   Email:  
Address:  
City:   State:   Zipcode:  

Marketing Contact
Name:   Title:  
Phone:   Fax:   Email:  

Royalty Contact
Name:   Title:  
Phone:   Fax:   Email:  

Other Information
Please list all product(s) you intend to manufacture using Mothwing™ patterns.
Please enter one per line and include the product name, and the projected retail price.

Projected product(s) retail price:  
Patterns desired:  
Type of decoration or fabric desired:  
Name of current decorator or fabric supplier:  
Territory desired:  
Distribution:  

Submission Requirements

The Manufacturing Authorization Application should be completed in its entirety and submitted with the following materials to Licensing Department via mail to P.O. Box 2019, Calhoun, GA 30701:

» Proper request to receive a manufacturing authorization on company letterhead
» Listing of all products to be decorated in MOTHWING™ pattern(s)
» Product sample of each item (products will not be returned)
» 2 Company catalogs or brochures
» 2 Photos of each item (if a catalog or brochure is not available).