<%mytitle="Performance License Form"%>

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PERFORMANCE LICENSE FORM

Please remember to supply your fax number or mailing address.
Fax or mail your request to Music Sales at:

Iris Torres, Synchronization Licensing Manager
Music Sales Corporation
257 Park Avenue South
New York, NY 10010
Tel: 212-254-2100
Fax: 212-254-2013
Email: it@musicsales.com

All permissions are completed by Music Sales Corporation in approximately 3-6 weeks.


	Name
	Organization
	Street Address
	City
	State
	Zip Code
	Phone Number
	Fax Number
	E-Mail
	Title of Piece
	Composer/Arranger
	Publisher
	Catalog Number
	Date(s) of Performance
	No. of Performances
	Ticket Price Per Seat
	Name of Performance Venue
	No. of Seats in Performance Hall