* Required Fields
I would like to request a fee quote for the following:
Contact Information
Salutation  
* First Name
* Surname  
* Company Name
* Street Address  
* Town / City  
* Province / State  
* Postal Code  
* Country  
 * Country Code  
Telephone Number
Best Time to Contact :      GMT
* Email Address
Re-Type Email Address
Song & Use Information
Song Title(s)
(List of songs requested)



Usage
(Type of usage and
brief description of the
context in which 
the song(s) will be used)
yes  no
  Visual Vocal
  Visual Instrumental
  Background Vocal
  Background Instrument
  Featured Background
  Musical Subject Matter
  Main Title
  End Title
yes  no
  Theme
  Bridge Music
  CD Cover Version
  CDG Karaoke
  DVD Karaoke
  Ringtones
  Other
          
Description of Use
Scope Of Use
(Rights needed)
yes  no
  TV (National)
  TV (Local)
  TV (Pay/Subscription)
  TV (Basic Cable)
  TV (Syndicated)
  TV (Satellite)
  Motion Pictures
  Radio
  Internet
    yes  no
  Non-theatrical
  CD Cover Album
  CDG Karaoke Album
  DVD Karaoke Album
  Download - Karaoke Video
  Download - Karaoke Audio Only
  Home Video Devices
  Other
           
Duration
(Anticipated length of time in
minutes and seconds that the 
segment will be used)
:
Term
(Number of years or 
“in perpetuity”)
Territory
(Regional, US, World)
First approximate broadcast/use date //

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