Company Name (if any)

Email *

Phone *

Song Title, Artist, Track Title *

Project Type *
—Please choose an option—TV ShowFilmTrailerPromoAdvertisementOther

Project Name *
project-name-example

Media Rights *
TVInternetRadioTheatricalOther

Length of Song Used *

Term Length *
1 Year2 Years5 YearsPerpetual

Territory *
WorldwideNorth AmericaEuropeAsiaCustom...

Estimated Budget *
$500-$1,000$1,000-$5,000$5,000-$10,000$10,000+