License Application for Mechanical

Church or Organization Name * Attention Address * City *

State / Province / Region * Postal / Zip Code *

Country * Email * Phone Number

Recording Information

Album Title * Artist Name * Release Date * Number of Copies * Number of Songs

Song 1 Title * Song 1 Author/Composer * Song 1 Copyright Year *

Song 2 Title Song 2 Author/Composer Song 2 Copyright Year

Song 3 Title Song 3 Author/Composer Song 3 Copyright Year

Song 4 Title Song 4 Author/Composer Song 4 Copyright Year Additional Titles or Special Instructions

* Indicates a required field