Electronic Philharmonic Online Music License / Order Form

This form is a contract between you and Electronic Philharmonic Music, authorizing the use of music from the EP Music Library for use in a specified Television, Radio, Film, and/or other media production. Please fill in the relevant information when using a cue of Electronic Philharmonic Music. When finished, hit "Send". You will be notified by email of receipt of this form, and Electronic Philharmonic will send you an invoice by mail and/or email.
Company Name:
Contact Name:
City:                       Date:
Title 1: Prog ID (if any):
Title 2: Prog ID (if any):
Title 3: Prog ID (if any):
Title 4: Prog ID (if any):
Title 5: Prog ID (if any):
Broadcast Usage (Select One):

Non-Broadcast and Commercial ($50.00) General Broadcast theme / background ($50.00)
(PLEASE NOTE: Music used as a theme or background in a broadcast program require a CUE SHEET filed with BMI)
Clips - less than :20

Usage (Select all applicable):

DVD     Internet     CD/DVD for Sale - Please call

I have the Electronic Philharmonic Music Library DVD
I do not have the DVD. Please send me a link to the download page

Make sure all your entries are correct, then hit "Send":   Remember to print a copy of this form for your records.
To download a license form in MS Word (.doc) format, CLICK HERE

Electronic Philharmonic - 4710 Olde Forge Court, Fairfax, VA 22032 - 703-250-3160