I, (name of applicant), do hereby apply for a license to
display the trademark of (association), "(trademark) "
at my place of business located at (address) , in
the City of , State of .
That this application is in accordance with the
regulations of the (trade association).
I am cognizant of the regulations of (trade association)
that govern the display of said trademark and the manner
of conducting business, and I agree to abide by such
regulations at all times.