Please fill out the form below and click "Submit".
  • Licensee Contact Information
  • Title of Your Project*
  • Production Company*Company/Network name
  • Contact Name*(Your Name)
  • Street Address*
  • City*
  • State*
  • Zip Code*
  • Country*
  • Phone Number*XXX-XXX-XXXX
  • Fax Number*
  • Email*example@example.com
  • Track Information
  • Song Title*
  • Artist(s)*
  • Composer(s)*
  • Publisher(s)*
  • Source Album*
  • Master Controlled By*Please check one.
  • Terms of Request
  • Advance**indicate unit of currency.
  • Length of Term*(years, months, days)
  • Release Date*
  • Territory*please be specific
  • Projected Sales*(in units)
  • Master Record Use Information
  • Title of your Album/Compilation*
  • Rights Requested*check all that apply
  • Royalty Rate (per-unit)**indicate unit of currency
  • Royalty Rate*will be based on
  • Total # of Tracks*on Album/Compilation