Cannabis Vendor Application
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Entity Information
Entity Name *
Mailing Address *
Mailing Address City *
Mailing Address State *
Mailing Address Zip *
Assumed Name (DBA)
Federal Employer Identification Number
*
Phone Number
*
Email Address
*
Website Address
Person Completing Application
Name of Individual Filling Out This Form *
Mailing Address
*
Mailing Address City
*
Mailing Address State
*
Mailing Address Zip
*
Type of Business
Type of Business *
Explain the Type of Business
Licensing Information
Provide License number if applicable:
Type of Activity Applying for at NMU
Type of activity applying for at NMU
*
Explain the activity *
Attestations
Authorization for Release of Information
*
License (If applicable) in “Good Standing”
*
Cannabis Attestation and Acknowledgment Form
Northern Michigan University must comply with the Drug Free Schools and Communities Act of 1989 (20 USC §1145g; 34 CFR §34). The Act requires, in part, that NMU have in place a program that addresses and prevents the use illegal drugs on its campus. Cannabis remains a Schedule 1 narcotic as defined by the United States Food and Drug Administration (FDA).

Given these compliance requirements, this Attestation and Acknowledgement Form is intended to make clear to external entities the terms and conditions of cannabis and cannabis related activities at NMU. This form in no way modifies, changes, or amends the NMU Drug Free School Act compliance policy and protocol which can be found at: https://nmu.edu/policies/1297.

No entity may engage in the promotion of actual retail sales of cannabis, including the cultivation, handling, warehousing, or distribution of cannabis for retail sales. This also includes, but is not limited to, the distribution of coupons, discounts, retail specific promotional materials such as key rings, flags, stickers, or other paraphernalia. On campus solicitation of employment in cannabis retail sales is also prohibited. This does not prohibit cannabis education, analytical study, and/or scholarship through open dialogue, exchange of information and ideas, including the study of the educational and academic aspects of retail cannabis sales.

In order to participate in NMU activities external entities must adhere to all NMU policies and all applicable state and federal law. Violation of University policy or applicable law will constitute grounds for the revocation of permission to participate in NMU activities.

Because cannabis is an emerging industry NMU will conduct due diligence on any cannabis retail entity to ensure that it is good standing with the Michigan Licensing and Regulating Agency (LARA). Entities must disclose if there any pending legal or administrative complaints against them and must inform the University of any such complaints file after the completion of this form. The mere filing of a legal or regulatory complaint will not disqualify an entity from participation but will be considered on a case by case basis. External entities may submit an explanation with regard to any such complaints.

By executing this form the external entities, through an authorized representative, acknowledges that they have read this form and agree to comply with the terms contained herein.
Cannabis Attestation and Acknowledgment Form for Participation in NMU Activities.
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Any supporting documentation can be emailed to mbath@nmu.edu.
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