Internal Campus Supplier Application

Contact Name
Name Name * First Last
Company Name *
Contact Information
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number Phone Number * - ### - ### ####
Email *
Business and Product Information
What is your business type? (Corporation, LLC, Proprietorship, etc.) *
Under what state is your business organized? *
How and where do you plan on selling the Vanderbilt University licensed product? *
What product(s) does your company offer? *
Please provide a link to the company website. *
Attach image of proposed product

Attach Files
Additional images

Attach Files
Additional images

Attach Files
Please provide any other additional information.
Definition of an Internal Campus Supplier:

An internal license allows a company to produce and sell product bearing the trademarks of Vanderbilt University and Vanderbilt University Medical Center for internal use only. An internal license does not allow for product at retail or direct to consumer.

Licensing Fee

A $100.00 application fee and $100.00 administrative fee will be charged by the University. The $200 fee is payable by CHECK and a signed agreement before the agreement can be approved. Please confirm that you will send payment to Vanderbilt University at the following address:

Loews Office Tower
Attn: Brand Engagement – Internal Campus Supplier Agreement
2100 West End Avenue, Suite 1100
Nashville, TN 37203

Please direct additional questions to brandengagement@vanderbilt.edu.

Internal Campus Supplier Application

Internal Campus Supplier Application

Contact Name

Contact Information

Business and Product Information

Definition of an Internal Campus Supplier: