Synchronization License Request
Please mail or fax this form to:
Shawnee Press, Inc.
Attn: Iris Torres
257 Park Avenue South, 20th floor
New York, NY 10010
it@musicsales.com
Fax: 212-254-2013
| Production Company Name/Licensee | Date |
| Address | |
| Contact Name | Phone |
| Fax | |
| E-Mail Address |
| Title(s) | Writer(s) (Arranger if applicable) |
| 1) | |
| 2) | |
| 3) | |
| 4) | |
| Publisher(s) | |
| 1) | |
| 2) | |
| 3) | |
| 4) | |
| Type of Media (Performance/Television/Commercial/DVD/Video): | |
| Number of Units to be Produced (DVD/Video): | |
| Type of Use/Duration: | |
| Air Date/Release Date: | |
| Term: | |
| Territory: | |
| **PLEASE ATTACH BRIEF DESCRIPTION OF USE** | |
| Internal Use Only |
|