APPLICATION TO BECOME A SHELBY® LICENSEE

Company Name:
Representative: Title:
Street Address:
City: State/Province: Postal Code:
Country:
Telephone:
Fax Number:
Email:
Company Website:
Product Description:

Intellectual Property to be used

SHELBY® CARROLL SHELBY®
CARROLL SHELBY'S SIGNATURE & INITIALS®
CARROLL SHELBY'S PHOTOGRAPH, LIKENESS & VOICE®
COBRA®
      (utilized under exclusive license from Ford Motor Company regarding 1960s Cobra vehicles)
COBRA SNAKE® logo
      (utilized under exclusive license from Ford Motor Company regarding 1960s Cobra vehicles)
289® 289 FIA®
427® 427 S/C®
SHELBY COBRA DAYTONA COUPE® GT-350®
GT-350H® GT-350R®
GT-350SR® GT-500®
GT-500KR® SHELBY SERIES ONE®
SHELBY SERIES ONE LOGO® SUPERSNAKE®
GT-H® SHELBY GT
KR® SHELBY AMERICAN®
"TERLINGUA RACING TEAM" LOGO®
      (utilized under exclusive license from Bill Neale)
TEAM SHELBY
Distribution Channels:   USA
  Canada
  South America
  Europe
  Asia
  Africa
  Other (explain):
Estimated Revenues: Year 1 $
Year 2 $
Product Origin: