Application for Reprint License

In order to handle your request, please provide us with the information on this questionnaire - required boxes are marked with *).

Name and address of the licensee

Publishing house / licensee *

Department / contact person: *

Street *

Postal / Zip Code *

City *

Country *

Phone

Fax

Email *

Information on the work used

Title of the work, composer, editor *

Title of the edition, edition-no. *

Number of pages (citation, measures etc.) *

Use of the engravings

Type of publication

Type of publication (songbook, collection, magazine/periodical, programme, dissertation, CD-booklet etc.) *

Published by *

Publisher's address *

Territory of distribution *

Date of publication *

Retail selling price *

number of copies published *

Total number of pages *

Total number of works *

The transmission of your inquiry does not inevitably claim the right for a reprint license for the work/material to be used. Our quotation for a reprint license will be submitted to you as soon as possible

Anti-spam protection

Please type the name of the composer.

I confirm that I am at least 16 years old.