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Licensing Form - Ads

Company Name Required

Company Address Required

Contact Details Required

Date

Title of Composition Required

Vocal or Instrumental Required

Product

Production Title(s)

No. of Ads & Length (e.g. 1 x 30 Seconds)

Storyboard/Script/Video URL Please include a URL where a Storyboard / Script / Video can be downloaded

Total Media Budget

Context of Use Please confirm what rights are needed
Background music/Incidental music
Title Music (over opening or closing credits)
Featured Usage
Out-of-Context Trailers

Media Please confirm what rights are needed
Free/pay TV for terrestrial broadcast: Cable, Satellite, VOD
Videogram cassette for retail sale and/or rental solely for home viewing, DVD, Laser Discs, Other
Theatrical Release
In-Context Trailers
Internet (streaming and/or downloadable, in-context use only )
Future Technologies
Film Festivals
DVD extras / making of

Territory Required

Period Required (e.g. 1 Year, Perpetuity, etc)

Proposed Fee Required

Other Information

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