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Please refer to our Definitions and Rate Schedule (PDF) for licensing details. (* fields are required)

My Information:
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Invoice To: *

Address: *

City: *

State: *

Zip: *

Country: *

Attn: *

Phone: *

 Ext.

PO #:

Email: *

 

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My Client's Information:

Client Name:

Production Title(s):

Cont'd:

Production Length:

Min. Sec.

Production Air Date:

Producer / Agency:

Commercial ISCI #:

First Line of Copy:

Type of Clearance:

Non-Broadcast-Corporate ?

Up to 500 Free Copies

 

Music on Hold

 

Unlimited Free Copies

 

Live Event / Trade Show

 

Museum Non-Profit Exhibit

 

Kiosk / Theme Park

 
 

Commercial / Promos ?

Radio

TV

  

Commercial, PSA or Promo, Local

 

 

  

Commercial, PSA or Promo, Regional

 

 

  

Commercial, PSA or Promo National 13 Week

 

 

  

Commercial, PSA or Promo National Unlimited

 

 

  

Internet (Banners)

 

 

  

Tags, How Many?

 

 

 
 

Programs ?

Radio Only

 

In Transit Only

 

Closed Circuit Only

 

Direct Broadcast Satellite Only

 

Cable TV Only

 

Free TV Only

 

Internet Only

 

All TV Rights (excluding Pay Per View)

 

All TV / Video Rights

 

All Media (excluding theatrical)

 

Pay-Per-View

 
 

Production for Sale ?

A/V Product Premium

 

Audio Cassette

 

Video Cassette / DVD

 
 

Computer Software / CD Rom

Production For Sale

 

Production Not For Sale

 
 

Production Blanket ?

Corporate

 

Program

 

Theatrical

 

Production For Sale

 

Computer Software CD ROM

 
 

Theatrical Production ?

Film Festival (1 year)

 

Trailer DVD / Video Only

 

Trailer All Rights

 

Film

 

Film All Rights

 

Theatrical Rights Package

 

Track Details:

 

CD #

Track #

# of Drops

Track Title

1

2

3

4

5

6

7

8

9

10

Additional Comments: