*Asterisk indicates required fields
First Name*
Last Name*
Primary Contact for Follow-Up*
Address Line 1*
Address Line 2
City*
State/Province*
ZIP Code/Postal Code*
Country*
Email*
Phone Number
Company Website
Are you a corporation?*
Country of Incorporation*
Principle Owners*
Number of Years in Business
Current Number of Employees
Is your primary business manufacturing? Which property would you like to use?
Check all that apply
Do you hold any current licenses with any other companies?
Listing Company
Years
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Does your company carry liability insurance?*
Insurance Carrier*
Amount of Coverage Dollars
As an individual, partner or an officer of a corporation, have you ever filed for bankruptcy voluntarily or been proceeded against involuntarily as a bankruptcy?*
Please give details (Date, court, case number, etc.)
Banking Institution
Address Line 1
Address Line 2
Primary Contact for Financial Information
Phone
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3. Tell Us About Your Product
How does this product fit the Goodyear brand?*
Is a prototype or sample of the proposed product available for review?* Would you be willing to source or manufacture products exclusively for Goodyear?*
Proposed Wholesale Price*
Proposed Retail Price*
Can you maintain an active inventory of the proposed product(s)?*
What product mix do you currently offer?
What resources do you employ for product research and development?
If any paint is used in manufacturing, is it lead and chrome free?
What type of packaging does your product require?
What is your production capacity to meet the anticipated customer demand?
What date do you anticipate that your product(s) will come to market?
Month
Select
January
February
March
April
May
June
July
August
September
October
November
December
Year
Select
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
If you will not manufacture the product(s), who is the manufacturer?
At the end of this form, you may attach an applicable MSDS for your proposed product. Return to top
4. Enter your Sales and Distribution Information
Under this license, how many units do you project selling:
In Year 1*
In Year 2*
Will the proposed product(s) be sold only by your own sales force?*
If your distribution is limited geographically, please list the states or countries*
Please list the distribution channels you plan to utilize*
(e.g. Retail, dealers, wholesale, direct marketing, trade shows, catalogs. If retail, please list specific retail stores.)
What is the size of your sales force (Number of representatives)?
What is your distribution capactiy?
What customer service / support capabilities do you have in place?
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What amount of advertising, promotion and merchandising funds do you plan to spend in support of this new licensed product for the first year, should you receive a license?*
What types of promotional mediums will be used to promote your product(s)? Please list specifics.
(e.g. Magazines, Press, Point of Purchase, Literature, Direct Mail, Catalogs, Co-op programs, Sales / Trade Incentives.)
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Please provide copies of any of the items listed in this form. (Acceptable file types are: pptx, xlsx, docx, pdf, jpg and png).