PLEASE READ
Priority will be given to forms that are easily legible and entirely filled in.
This
form is written to make this process easier for you. So use it
Requestor Information
Your Name_______________________________________________ Date of Request______________
Phone
#___________________________________Fax #_______________________________________
Email________________________________________________________________________________
Record Label (if applicable)_____________________________________________________________
Label Address (if you are not using a Record Label, provide your mailing address)
Address______________________________________________________________________________
City______________________________________State__________Zip Code_____________________
About
Your Record
Artist (if compilation do not put “Various”)____________________________________________________
Record Title___________________________________________________________________________
Record
Number__________________Release Date________________Song Playing Time_____________
Anticipated
Quantity of Units (please circle):
Over 5,000
Under 5,000 (if under please fill out chart)
CONFIGURATION
QUANTITY
For download requests also provide: CD/DIGITAL DOWNLOAD/VINYL
Digital UPC #_______________________________
DOWNLOAD (please estimate)
ISRC #_____________________________________ TOTAL
Information
About The Song You Wish To Use
Title (s)______________________________________________________________________________
Writer(s)_____________________________________________________________________________
Publisher(s)__________________________________________________________________________
Once
this form is complete please Mail to:
Cosmic Trigger Inc.
217
East 86th St #151
New York, NY 10028
Or FAX to : 212 262
6299
Please allow 10-14 business days to process your request before following up.
