Please fill out the form below and click “Submit”. Form Name:*Sample Request Licensee Contact Information Title of Your Project* Production Company*(company/organization) Contact Name*(Your Name) Street Address* City* State* Zip Code* Country* Phone Number*XXX-XXX-XXXX Fax Number* Email*example@example.com Master Information Song Title* Artist(s)* Composer(s)* Publisher(s)* Source Album* Greensleeves Publishing, LTD*Controlled share % STB Music, Inc*Controlled share % Terms of Request Length of Term*(years, months, days) Release Date* Territory*please be specific Projected Sales*(in units) Interpolation/Sample Use New Composition's Title* New Composition's Artist(s)* New Composition's Writer(s)* New Comp. Publisher(s)* Submit
