License Application

License Contact

Name*
Address*
Phone Number*
Email*

License Request

Production Title*
Production Client*
Production Length*
ms
Date of Use
P.O.#

Type of Production

TV Commercial
Radio Commercial
Cable Commercial
Tags for Local Spots
Broadcast Program
PSA
Non-Broadcast
Theatrical Production-Film
Trailer
Production for Sale (up to 10,000 copies)
Other Use (Please Specify)
Production Blanket
Annual Theme License

Tracks

Library ID and CD# (e.g. AT023, MPM007) Track # of Uses
1