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Liben Music Publishers
Application for Public Performance License



Use this form to obtain permission to use any of the copyrighted recorded material in our Red Mark CD and DVD Catalog as background or featured music in a live public performance venue.



Date


Title of the work you would like to use.


Composer of Music


Author of Text (if any)


Title of CD or DVD


CD or DVD Catalog No.


Number and Name of Track(s)


Exact duration of Track(s)


Name of Public Venue


Full Street Address


Capacity of Theatre


Title of Production


No. of Weekly Shows


Performance Dates
(opening - closing)


Name and Title of Person Responsible
for Execution of this License


Full Street Address


Telephone No.


Fax No.


Web Site


E-mail Address


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