Form to Request Copyright Permission - Sheet Music

See instructions for filling out copyright request forms


Instructor:
Course #:

Title of composition:


Composer(s) [please include first and last name(s)]:

Date published:
Publisher:

Title of anthology:

Compiler(s) [please include first and last name(s)]:

Date:
Pages:

Publisher:

If selection is taken from a web site, state the complete web site name and address:

I am asking for (select one):
photocopy rights      electronic rights

If used at web site, state URL:

If used at web site, is the site password protected?  Yes      No

If you would like a copy of this form enter e-mail address: