EcoLabel Registration Application

Company Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

EcoLabel manufacturer ID code (assigned by ICMA upon licensee approval):*

Name*

First Last

Email Address*

Telephone Number*

Card Product (Be specific; this name should match and be referenced on all other submitted documentation.):*

Product Marketing Name:*

Association Approved Construction Number (for Financial Cards Only), otherwise, enter N/A:*

Type / Use of Card:*

Name of Card Issuing Companies/Organizations - Current or Potential:*

EcoLabel Desired*

Do you want to display the label on the card? (This is optional, and an additional display fee will be charged.)*

Upload Product Construction Drawing*

Max. file size: 48 MB.

Upload Association Approved Construction Number/Letter of Approval (Financial Cards Only)

Drop files here or

Max. file size: 48 MB.

Select the Assurance Level Desired - Declared or Verified*

Declared
Declared, with the intent to verify the product for certification at a later date
Verified

Upload Third Party Assessment Report*

Max. file size: 48 MB.

Signature*

Date*