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About
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Roster
Placements
Shows
Samplers
Contact
Synchronization Licensing & Publishing
Sync Request Form
Company Name
*
Street Address
Address Line 2
City / State / Zip Code
Contact Name
*
First Last
Phone
*
Country
(###)
###
####
Email Address
*
Title of Composition
Writer / Composer(s)
Work Recording
Original
Cover
Vocal / Instrumental
Project Title
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:
* Please note that all the below media will be licensed expressly excluding future technologies unless these are requested as part of the initial license. Future technologies can not be granted as an option. ** Please also note that SOUNDTRACK RIGHTS are not included and if required will be negotiated separately.
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 (please specify)
Theatrical Release
In-Context Trailers
Internet (streaming and/or downloadable, in-context use only)
Future Technologies
Film Festivals
DVD extras / making of
Territory
Period
(e.g. 1 year, perpetuity etc.)
Proposed Release Date
MM
DD
YYYY
Duration
(e.g. 30 seconds)
Synopsis/Scene Description
Please provide the following:
Full Synopsis of Film/Program/Project
Production Company
Name of Distributor
Additional Comments
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