REQUEST FOR ASCAP/BMI LICENSE
(Performances occurring after January 1, 2003)

Please complete and mail this form along with your payment (make check payable to Sweet Adelines International) no later than 10 days following your event to: Music Service Department, Sweet Adelines International, PO Box 470168, Tulsa, Oklahoma 74147-0168.  If you have any questions, call international headquarters at 800-992-7464, ext. 123.

*NOTE: If you are having more than one performance (show), complete a request for each.  An ASCAP/BMI/SESAC license will be issued for each performance.  Fees are based on the actual seating capacity of the concert hall and the total gross revenue.  Gross revenue means all money received from the sale of tickets for each performance.  Music Services Department will provide the rate schedule for seating capacity over 5,000 upon request.

Chapter Name     Chapter #     Region # 5

Region Name (if this is a request for a regional event)

Date of Performance (*see above note)

Name of Facility

Location of Facility (city and state)

ASCAP RATE

Fill in the blanks and check the appropriate box for your event to calculate the ASCAP fee:

Ticket Price $     times Tickets Sold = Gross Revenue $

Seating capacity is 0 - 2,500 - Gross Revenue $ times .0068 = Total ASCAP Fee $
                                (** or Minimum Fee of $22.00)

Seating capacity is 2,501 - 5,000 - Gross Revenue $ times .0045 = Total ASCAP Fee $

Free admission event at a location with seating capacity of 5,500 or less = Total ASCAP Fee is $22

Example:    Ticket Price $10 x Tickets Sold =  750  = Gross Revenue $7,500
                    With seating capacity of 1,000 multiply times .0068 = Total ASCAP Fee $51.00
                    With seating capacity of 3,000 multiply times .0045 = Total ASCAP Fee $33.75

ASCAP fee submitted (Minimum fee is $22.00)			$
BMI fee submitted			$
add SESAC flat fee			$ 9.50
Total Enclosed			$
Licenses will be mailed to the person listed below:
Name
Membership #
Address
Daytime Phone

~BMI FEE BASED ON SEATING CAPACITY ONLY~
Seating Capacity	BMI Rate
0 - 1,500	$20.00
1,501 - 2,500	$30.00
2,501 - 5,000	$50.00
5,001 - 7,500	$68.00

Please complete the following if using a credit card:

Visa    MasterCard
EXPIRATION DATE

                   Card Owner's signature - must be signed

 Calendar Home