Please fill out the form below and click “Submit”. Form Name*Publishing License Request 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 Song Information Song Title* Artist(s)* Composer(s)* Publisher(s)* Source Album* Greensleeves Publishing, LTD*Controlled share % STB Music, Inc*Controlled share % Terms of Request License Fee*(for 100% of the composition) MFN*with co-publishers and master owner?YesNo Advance**indicate unit of currency. Length of Term*(years, months, days) Release Date* Territory*please be specific Projected Sales*(in units) Synchronization Use Description Title of your project* Usage Type*check all that applyIn-contextOut-of-contextOpening CreditsFeaturedBackgroundClosing Credits Rights Requested*check all that applyFilmTelevisionHome Video/DVD/Blu-RayWeb/OnlineDownloadStreaming/Video-On-Demand Length of Use*Runtime in minutes and seconds Brief Information*Please provide a brief synopsis of your project Brief Description*Please provide a description of the use Production's total budget**indicate unit of currency Mechanical License Title of Track* Name of Artist* Composers* Album Title* Record Label* Email*can't leave this empty Comments*further details You can use this to write comments in the form.You can even use HTML! Submit