Music Grand Rights Clearance Request

Date: January 15, 2010

To:

From:

Department of World Arts and Cultures

Box 951608

Los Angeles, CA 90095-1608

Phone: (310)

Fax: (310) 825-7507

E-Mail:

Re: Grand rights clearance of selection: ______

______

______

For: The UCLA Department of World Arts and Cultures dance/theater performances created by choreographer ______

under “non-profit organization status”.

I am writing to request clearance to use the song ______

______for original choreography.

I am additionally requesting permission to alter this composition in the following ways:

Specifics regarding the performance:

Performance Name:

Performance dates:

Location of the performances:

Seating capacity:

Admission will be charged:

Non-profit status: We are a non-profit educational institution which seeks to promote dance in varied contexts, to provide our students pre-professional training and opportunities for performance and production work, one of which is this recital.

Documentation: Other than an archival video of performance, no recording will be made.

Your provision of clearance to use the music selection will be most appreciated. Please do consider waiving and/or reducing any royalty charges. I hope to hear from you soon regarding this request.

Sincerely,


Music Master Rights Clearance Request

Date:

To:

From:

Department of World Arts and Cultures

Box 951608

Los Angeles, CA 90095-1608

Phone: (310)

Fax: (310) 825-7507

E-Mail:

Re: Master rights clearance of selection: ______

______

______

For: UCLA Department of World Arts and Cultures dance/theater performances created by choreographer ______

under “non-profit organization status”.

I am writing to request clearance to use the song ______

______

______for the original choreography.

Specifics regarding the performance:

Performance Name:

Performance dates:

Location of the performances:

Seating Capacity:

Admission will be charged:

Non-profit status: We are a non-profit educational institution which seeks to promote dance in varied contexts, to provide our students pre-professional training and opportunities for performance and production work, one of which is this recital.

Documentation: Other than an archival video of performance, no recording will be made.

Your provision of clearance to use the music selection will be most appreciated. Please do consider waiving and/or reducing any royalty charges. I hope to hear from you soon regarding this request.

Sincerely,