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Title of Show Requested for Licensing
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Name of Theatre Company/Producer
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Theatre/Venue Name
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Theatre/Venue Address
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Seating Capacity (including standing room, if applicable)
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Type of Stage
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Type of Production
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Union Status
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Start Date (First Performance or Preview)
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Closing Performance (leave blank if open-ended)
Number of Performances (include previews; enter "TBD" if open-ended)
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Anticipated Ticket Pricing/Admission Range, if applicable (for not-for-profit or educational productions, please list your expected ticket range e.g. $20 - $40. For commercial productions please enter "TBD" or "Market Priced.")
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Type of Rights Requested
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Contact Name
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Email Address (official correspondence will be sent to this address)
*
Phone Number (optional, for time sensitive questions only)
Additional Notes/Comments (optional, include any details you wish us to know that are not covered above)
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