Request a Mechanical License

To request a mechanical license, please provide the following information. Those items marked with an "*" are required fields and your request can not be submitted without completing this information. License Request via the internet are only available on behalf of publishers listed in the pull down box under the publisher field.

Please note that it takes 4-6 weeks for requests to be processed. Royalty amount due will be included in the license sent to you.

If you have any questions, please contact Robin Moore

Song Information

*Title of Work:

 
*Author/Arranger  

*Publisher:  
*Duration of Work:  
*Title of Project:  
*Artist:  
Label:  
Project Number:  
Configuration:  
*Number of Units:  
*Release Date:  
     

Contact Info
*Contact Name:  
*Company Name:  
*Street Address, City, State, Zip:  
*Contact Phone:  
Contact Fax:  
*Contact E-mail:  
     

Licensee Info (If Same as Contact Info Leave Blank)
Name:  
Company:  
Address:  
Phone:  
Fax:  
E-mail:  

Press 'Submit' button after completion