ESV Music Permission Request Form

Name:
Email Address:	This is how we will follow up with you.
Address (street, city, state, zip, country):
Phone number:
Are you an individual or a company?
Company name:
Company website URL:

Detailed Description of Product that Will Quote ESV

Product type:
Title:
Product description:
Composer:

ESV Usage

Number of verses featured in each individual composition:
Bible passages included:
For each composition, what percentage does the ESV text make up of the total text?
Check box if you plan to edit or revise the ESV text:
Explain:

Distribution

Check box if this product will be sold:
Provide pricing model:
Publishing plan:
Publisher name:	Publisher name is required to receive permission.
Expected publish date:	YYYY-MM-DD
Distribution channels and formats: