百胜商标使用申请表-Orbyfaxat+390106520172.PDFVIP

REQUEST FORM FOR USE OF THE ESAOTE TRADEMARK To be completed and sent to Esaote S.p.A.’s Office of Communications and External Relations by e-mail at: communications@ Or by fax at: +39 010/6520172 Name and Surname_______________________________________________________ Acting as representative for _____________________________________________________________________ Central Office________________________________________Tel.________________ E-mail:_____________________________________________ Requests the use of the “Esaote” trademark, to promote the following initiative: ______________________________________________________________________ For the purpose of which, the details below stipulate: Place and date of the initiative ______________________________________________________________________ Promotional materials on which the “Esaote” logo will be reproduced: ? Posters ? Brochures ? Leaflets ? Videos ? Newsletters ? Books and published materials ? Webpage at: www.___________________________________________________ other ____________________________________________________ Circulation area of the materials ? Local ? Regional ? National ? International 1/3 Trademarks of other organisations or public institutions (if present) ___________________________ Commercial trademarks (if present) _____________________________________________________ Format requested for sending the trademark: ? Vector-graphics format (.eps) ? .jpg ? .tiff other___________________ Operating system used: ? Macintosh ? Windows, Linux Email address to which the logo should be sent: ______________________________________________________________________ Request for further materials connected to the Esaote trademark: ?