Copyright permission forms should be mailed or faxed to:
The Healing Music Organization
P.O. Box 3731
Santa Cruz, CA 95063 USA
Fax: 831-401-2655
E-Mail Us
Print this form. Please provide complete information. Your request will be reviewed, and a response will be sent to you as soon as possible.
I request permission to copy the listed material for the following use (see below):
Requested By:
____________________________________
Company:
________________________________________
Address:
_______________________________________________________________
Telephone:
_______________________________________
Fax:
______________________________________________
ARE YOU AN HMO MEMBER?
O - YES /
O - NO
MATERIAL TO BE USED:
O - Photo/Illustration
O - Article
O - Other (specify) __________________________________
Publication (Title, Vol., No., Pg.):
_________________________________________
Article Title: __________________________________________________________
Pages: ___________________________________________
No. of Copies & Copying Method: _________________________________
PROPOSED USE OF COPYRIGHT MATERIAL (please give detailed description):
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
We thank you for your request for copyright permission. We will review your request, and email you shortly with our decision.
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