SYNCHRONIZATION VIDEO LICENSE REQUEST
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Licensee Name:
Contact Name:
Address:
Phone Number:
Fax Number:
Email:
Composition:
Writers:
not performers
Master recording:
Production Title:
Type of Production:
Synopsis:
Scene Description:
Background or Visual Use?:
background
visual
Vocal or Instrumental Use?:
vocal
instrumental
Timing of Song Use:
Media:
i.e. DVD, VHS, Laserdisk, etc.
Territory:
where the product will be sold, i.e. US or Worldwide
Term:
Start Date:
Options:
# of Units initially manufactured:
Retail/Wholesale Price:
Parody Lyrics:
Production/Music Budget:
Comments:
