Song License Request Form

You are requesting license information for:

Artist:
Even the Odd
Song:
Hey Hey

Please provide the following information:

* denotes required information

*Your Name:
Your Title:
Your Company:
Your Address:
*Your Phone:
Your Fax:
*Your Email:
*License Type:

If "Other," please specify:

*For Use In:

If "Other," please specify:

If for use in film or tv, please specify:

If for use in film or tv, duration of use:
min. sec.

Proposed License Fee:

(for non-Mechanical license only):
$

Territory:

If "Other," please specify:

Brief description of your project:
Date License Required by (mm/dd/yyyy)
/ /

Press "Submit" below to send the above information to FlightSafe Music.