APPLICATION FOR ANNUAL MUSIC COPYRIGHT LICENSE

This license is for the copying of music only. It is for the purpose of playing and singing in religious
worship, by church musicians and choirs, and is subject to the conditions as set out below. 'Music'
as referred to in this license means any keyboard , guitar, harmony or choral, or instrumental parts.
I/We, the undersigned, apply for a license from WORD OF LIFE INTERNATIONAL which, subject to the
terms & conditions set out below, authorizes the multiple copying of protected copyright works.

Classification

Church Premises Only

Whole of Parish(E)

AA. 0-100 Attending Church PW

AUD$96.80

AUD$107.80

A. 101-750 Attending Church PW

AUD$176.55

AUD$211.20

B. 750 Plus Attending Church PW

AUD$330.00

AUD$381.70

C. Other Organizations

AUD$176.55

 

Use the Following Form to Place an Order
If you are Posting this Form. Please Print , Complete and Sign the Form

 
Licence Type Selection:           Licence Applied for : 
                    For License "B" please select classification. 
                                   (Use arrow in right of box of these boxes to make the selections)
If you are Posting this Form. Please Print , Complete and Sign the Form

    Name :

    Organization:

      Address 1 :

    Address 2 :

      City :

State :

      Zip Code :

Country:

     Voice Phone :

     Fax :

      Email:

 

Applicant please sign here ................................................................................................. Date.............................

Signed on behalf of Word of Life ........................................................................................ Date.............................

 Billing Information: (If you do not wish to use a credit card please Print this form or Complete a letter indicating licence type etc, and Enclose a cheque) Credit Card Cheque

  Credit Card :

Amount Due $$$$ :

  Card Number :

Exp: (MM/YY)

Cardholder Name:

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