Montbell Challenge Support Program Application Form
Date :
CHALLENGE DESCRIPTIONTITLE OF CHALLENGE / ACTIVITYNAME OF INDIVIDUAL / TEAM / ORGANIZATIONNAME OF APPLICANTNAMES OF THOSE ATTEMPTING THE CHALLENGETYPE OF CHALLENGE
OTHER:PURPOSE OF THE CHALLENGE （WRITE CONCISELY）

DESCRIPTION OF THE CHALLENGE （Include the area and duration of activity)

REQUESTED SUPPORT□ Purchase Support□ Product Sponsorship□ Financial Sponsorship

Requested Amount:

Requested Amount:

Requested Amount:※Montbell products only. Reviewed and evaluated four times a year.
※Montbell products only.
FINANCIAL SPONSORS (If there is/are, from whom, how much and how long are you receiving sponsorship?)

OTHER SPONSORSMEDIA EXPOSURE (TV, Magazine, Newspaper)

Office Use Only
Receipt Number

Activity category

Accepted Date

（Continues on the second page）

APPLICANT CONTACT INFORMATIONTELEPHONE
TEAM NAME /ORGANIZATIONFAX
M / F

TELEPHONE

NAME
AGE

FAX

ADDRESS

E-MAILWEBSITEHISTORY WITHMONTBELL
Montbell Member Number

INVALID WITHOUT SIGNATURE
AGREEMENTI duly agree with the below:・ When the applicant(s) is(are) under age, the signature of a guardian(s) is(are) mandatory.
・ Applications will be reviewed and evaluated by the Challenge Support Program.
・ Your Challenge may be publicized through Montbell's websites or magazines and promoted by other means.
・ Your activity may be publicized for the purpose of enhancing the Challenge Support Program.
・ The applicant(s) is expected to be cooperative with Mont-bell logo exposure and brand appeal.
・ A Final Report must be submitted within one month of completing the Challenge. The Final Report is free format,
however it must include all information covered in the Final Report Guidelines.
・ Your Final Report, photos and video of the Challenge may be used for promotional purposes in Montbell's catalogues,magazines and websites.

Signature（For under age applicants） Guardian's Signature■ Privacy information
The information provided by the applicant will only be used for contacting the applicant and publicizing your Challenge.
Without the permission from the applicant, this information will not be used for any other purpose.

Submission Checklist□ Application Form□ Product List
□ Budget Plan
□ Challenge Plan
□ Your/team's history （free format）

Product List

※Montbell products only.

REQUESTED SUPPORT （Please circle）
Discounted Product Purchasestyle #product nameProduct Sponsorship
unit pricequantitysubtotal

123456789101112131415

Total Requested Amount

What other brands are you planning to use besides Montbell?
Brand nameName of productcategorye.g. tentBudget Plan
Duration ：○ Income
AMOUNT
PRIVATE FUNDSSPONSORSHIPDONATIONSINCOMETotal○ Expenses
AMOUNTEXPENSESTotal

Challenge Plan
○ Location○ Duration○ Name of Challenger(s)○ Schedule
DateLocation

Montbell Challenge Support: Final Report Coversheet
Please submit this report within one month of completion of the Challenge.
Please provide us with a report on your Challenge following the guidelines below.
Challenge Title

AuthorName of Challenger or Team

Challenge Date
Final Report Guidelines
・ Final Report・ Based on the submitted Challenge Plan, write a detailed report of the Challenge.
・ Was the Challenge a success? Did you encounter any hardships?
・ Can you share an exclusive story from your Challenge?
・ Product Support
・ How did Montbell's products perform?
・ What were your favorite Montbell products?
・ Please provide both positive and negative feedback.
・ Product Ideas
・ During your Challenge, did you have any ideas for new products?
・ Did you feel that any of Montbell's products could be improved upon?
・ Did you have any ideas for a new feature for existing gear or clothing?
・ Future Goals and Plans
・ After completing your Challenge, do you have any new goals?
・ Do you have plans to continue your Challenge or plans for a new Challenge?
・ List of media featuring your Challenge
・ List any media outlet that featured your Challenge.
・ If possible, please provide copies of print media.
・ Please provide links to internet articles.
・ Picture Guidelines
・ When possible, try to take pictures that show the challenger(s) being active.
・ When possible, try to take pictures that feature the Montbell logo and products.
・ Provide all pictures, regardless of whether they feature Montbell Products.

Questionnaire: Would you like to appear at a Montbell Store and give a presentation on your Challenge? Y / N ?
Checklist (Please mark)□ Final Report (including this coversheet)□ Pictures from the Challenge□ Pictures featuring Montbell Products□ Copies of any articles or other media

Pictures:・Send pictures by email, DVD or CD-ROM (via mail)