The Icon1901 Collective Interest Form Name * First Name Last Name Email * Website http:// Phone (###) ### #### Is your business incorporated? Yes No Business location Name of Authorized Representative First Name Last Name Are there any lawsuits pending against the business, or any unpaid federal, or state taxes? Yes No What name, image, and likeness activity is your company interested in the student athletes performing? Activities included, but not limited to social media endorsements, commercials, appearances. autograph signing, and other similar activities in which a business, brand, product or service is promoted. How long of an engagement are you interested in? * 1 - 3 Months 3-6 Months 1 year 4 years Which sport or team are you interested in working with? Is there any other information you would like to share? Provide all social media handles including, but not limited to: Facebook, Instagram, TikTok, Reddit, Twitter, Snapchat, LinkedIn, etc. Leave a space after each name. Thank you!