Play Any Key Music (ASCAP) - Durgon Style Music (BMI)
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Mechanical License Synchronization License Master Use License

Synchronization License Request Form

We will fax a quote within five (5) business days
from the day we receive your request.

Download the PDF version here.


First Name:*
Last Name:*
Company Name:*
Company Address:*
Company Address 2:
City:*
State:*
Zip Code:*
E-Mail:*
Phone Number:*
Fax Number:*

Song Title:*
Songwriter:*

Name of Production:*
Distributor/Production Co.:*
Production Budget:*
Music Budget:*
Brief Synopsis:*
Detailed Scene Description:*

Use in Film Credits:*

Use in Film Credits will have an impact on the license fee quote.
.

Duration of Use:*

The Duration requested will have an impact on the license fee quote.
.

Media:*
The Media requested will have an impact on the license fee quote..

Term:*

The Term requested will have an impact on the license fee quote.
.

Territory:*

The Territory requested will have an impact on the license fee quote.
.

Comments:

Please list options in the Comments box above.
.

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