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Computer Games Licence Form

Fields marked with a * are mandatory

Contact Name

*

Company Name

*

Address

*

Phone

*

Fax

Email

*

Confirm Email

*

Song/Track Title

*

Writer

Artist

Name of Game

*

Game Synopsis

Type of Use (i.e Titles / Soundtrack)

*

Timing (secs / mins of use)

*

Territory

*

Territory of Manufacture

*

No. of Units

*

Buy-out/royalty rate offered

Expected Release Date

Term of Use (6months / 1yr)

*

Special Conditions