Name * Inquirer's Name Email * Phone * Billing Address * Is shipping address different * Yes No Shipping Address * Organization * Requested Title * Composer/Arranger * Publisher/Imprint * - Select -EB MarksEdwin F. KalmusLauren Keiser MusicLudwigMasters PublicationsSouthern Music Company Copyright Year * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Request Type * - Select -Academic PermissionArrangement for commercial sale (sub-publishing)Arrangement for private or organizational useBroadcast, RadioBroadcast, TelevisionDigital, Internet or StreamingGrand RightsMechanical RightsPhotocopy PermissionSynchronization for Film or TVOther (please specify) Other Request Type * Permission Term Start Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202120222023 Permission Term End Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202120222023202420252026 Territory * (Please specify which Country, Region, or “World”) Additional Details Leave this field blank
