Please provide the following information. Note that items marked with an * are required fields and your request can not be submitted without completing this information. Mechanical License Requests are only available on behalf of publishers listed in the pull down box under the publisher field.
Please allow 4-6 weeks for requests to be processed. Royalty amount due will be included in the license sent to you.
For more info email Robin Moore at firstname.lastname@example.org or call 800.826.9996.
* Title of Work:
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* Duration of Work:
* Title of Project:
Configuration (CD, MP3, etc.):
* Number of Units:
* Release Date:
* Contact Name:
If Same as Contact Info Leave Blank.