Song Lyrics Publishing Permission Request Form
Your Name
Organization / Affiliation
Email Address
Phone Number
Song Details
Song Title
Songwriter(s)
Publisher
Portion of Lyrics Requested
Usage Details
Purpose of Use
Type of Publication
Print (Book, Magazine, etc.)
Website
Audio/Visual
Other
Distribution Details (where/how will it be published)
Estimated Circulation / Audience Size
Expected Publication Date
Additional Information