Please fill out this Performance Notification form, if the music you are licensing from Melodies Music is to be played on any media (from appearing in a film to being broadcast on the Radio or the Internet or being used in public environment such as fashion shows, shops or business conferences). Please complete the details of how and where the music is used.

Your contact details

Your Name:

Email:

Address:

Telephone:

Name of
Production Company

Contact Name

Production Companies
Address:

Telephone:

Publication details

Music details

Enter song titles and length used for each track used in the broadcast. If there are more than 5 tracks, use another form.