License > License Request Form
Synchronization License for In-House Use Request

Additional Forms:
Mechanical License
Digital Download License
Synchronization License for Commercials
Synchronization License for Film
Synchronization License for Film Festivals
Synchronization License for Games
Synchronization License for In-House Use
Synchronization License for Merchandising
Synchronization License for Stage Play
Synchronization License for Television
Synchronization License for Video
Synchronization License for Websites

Agency:
 

Contact Name:
 

Licensee Name:
 

Address:
 

City:
 

State:
    Zip Code:

Country:
 

Daytime Phone:
 

Fax Number:
 

Your Email Address:
 

Production Title:
 

Composition:
 

Writers (not performers):
 

Master recording or re-record (if master, list Artist):
 

Number of Uses of Musical Work in Production:
 

Timing of Song Use:
 

Usage:
 

Media (i.e. Multimedia, VHS, CD-ROM, etc.):
 

Territory:
 

Term:
 

Start Date:
 

Options:
 

Number of Units:
 

Will copies be distributed?
  Yes     No

At what price?
 

Who will view?
 

Number of viewers at each presentation:
 

Number of presentations:
 

Will admission be charged?
  Yes     No

How much?
 

Parody Lyrics:
 

Production Budget:
 

Synopsis:
 

Scene Description:
 

Comments:
 
   
 
     
     
     

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