Request For Approval to Use RedPalmWeevil.com brand Features

Print this form, provide the required information on separate sheets, and fax your request to  011 966 3 5802073, or scan it and email it to alhudaib@hotmail.com .

Please include:

1-   Exact name and title of organization and/or person requesting permission, and contact information (e-mail, phone, fax, mailing address).

2-    Describe and attach the sample of visual that features.

3-   Specific description of materials in which www.redpalmweevil.com or copyrighted materials will appear. 

Signed:  

Name:

Title:  

Web Sit:  

Date:  

Organization:  

E-mail:  

Address:

PO Box:

City:

Country:  

Telephone:

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Copyright 1998 - 2006 Khalid A. Alhudaib
Last modified: 1/1/ 2007