Brand Affiliation Form

Brand Affiliation Form
IMPORTANT NOTICE: This office will be closed from 12/24/25-1/5/26, with limited staffing from 12/16/25-1/9/26. If this request was submitted prior to 12/11/25 it is likely to be processed prior to the holidays.
The office will reopen on 1/5/26.

Member Organization Information
What is the group's name?*
Group affiliation (please select all that apply)*

I am part of this groupMy unit is part of this groupOther
Please describe the affiliation
Contact for the group

First NameLast Name
Contact's Email
example@example.com
Contact's Phone Number
Please enter a valid phone number.