TV Commercials License Request Form

Fields marked with a * are mandatory

Contact Name

*

Company Name

*

Address

*

Phone

*

Fax

Email

*

Confirm Email

*

Song/Track Title

*

Writer

Artist

Product being Advertised

*

Brief Commercial Synopsis

Type of Use

*

Media (i.e TV / Web / Cinema)

*

Timing (secs / mins of use)

*

Territory

*

Expected Air Date

No. of Transmissions

Term of Use (1yr / 2yrs)

*

Special Conditions