Permission Request to Quote Music in a Dissertation

Please mail or fax this form to:

Aida Garcia-Cole, Print Licensing Manager
Shawnee Press, Inc.
257 Park Avenue South, 20th floor
New York, NY 10010

Fax: 212-254-2013

Thank you for requesting permission to use our copyrighted material. Before we consider your request, please supply us with the following information:

 
Your Name
 
Name of Organization Performing Arrangement
 
Address
 
City, State, Zip / Postal Code, Country
 
Phone Number E-Mail Address / Fax Number
 
Title of the Composition Edition Number
 
Name of Composer
 
Counting from the beginning of the work or movement, please provide the exact measure numbers to be quoted.
 
Name of University Granting Your Degree
 
Advisor's Name and Department
 
Anticipated Date of Completion (Month and Year)
 
Will the dissertation be submitted to University Microfilms, Inc.?


Please attach additional pages for comments and clarifications. Your request will be considered for the necessary license. Our reply will include the acknowledgement which must appear under each excerpt cited. Thank you for your interest in our music.