International Music Co. Photocopy Request Form

PHOTOCOPY/SCORE CREATION QUESTIONNAIRE For photocopy/score creation requests, please provide the following information and return this questionnaire to us via post, e-mail, or fax, accompanied by a copy of the receipt or invoice for your purchase of the IMC edition that you would be copying.

Date:

Name:

School:

Address:

City:

State/Province:

Zip/Postal Code:

Telephone:

Fax:

E-mail:

Edition Number:

Title of Work:

Composer:

Instrumentation:

Number of Scores you wish to make:

Number of Performances:

Date(s) of Performance(s):

Name and Address of venue(s) where performance(s) will take place:

This questionnaire does not grant permission to reproduce the music of any IMC Edition. Upon our receipt and review of the information and material requested above, we will contact you.