REGISTER & AP
REGISTRATION FORM
* Required

Composer (music)
Author (lyrics)
Both
*
*
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(only if you would like your royalties and performance statements sent other than to the above address)
* UNITED STATES
Yes
No
SUBSTANTIATING WORK INFORMATION To qualify for royalties, you must be the artist or co-artist of a least one musical work or song. You must grant D’Cohca Publications via www.recordsongs.us the right to all or a minimum of one of the following: The song(s) must be commercially recorded, and published by D’Cohca Publications. The song(s) must be performed publicly, in any venue, or medium licensable by D’COHCA. The song(s) must be performed in any audio visual or electronic medium, or published and available for sale or rental as sheet music, a score or folio by D’COHCA. 
Please complete ANY of the following conditions (A, B, C, D) you meet before you can qualify for membership in D’Cohca Publications via www.recordsongs.us and provide the information requested based on the musical work or song listed above:
A.) Has the song been used as a public performance in any venue licensable by ASCAP?: (club, live concert, symphonic concert or recital venue, college or university, etc.)
Performer(s):
Name of Venue:
B.) Has the song been a performance in any audio visual or electronic medium: (CD, Film, television, radio, Internet, cable, pay-per-view etc.)
Medium:
Title or name of film, television program, website, radio station:
Date of Performance:

* D’Cohca Publications via www.recordsongs.us must have your permission to select your song to be published and to pay you royalties, and permission to license if the song was released in the past.
C.) A commercial recording
Recording Artist:
Date of Release*:
Record Label (includes independent or
self-releases):
* D’Cohca Publications via www.recordsongs.us must have your permission to select your song to be published and to pay you royalties, and permission to license if the song was released in the past.
D.) Has the song been published on sheet music, score or folio available for sale or rental
Title of published sheet music,
score or folio:
Publisher:
H-W-ENG-2007-08 ASCAP

Please select the type of musical genre you primarily work in (check only one):
Popular
Symphonic/Concert Music (works for orchestra, chamber ensemble, chorus, wind ensemble, concert band, solo instrumental, electro-acoustic forces, etc.).

WARRANTIES AND REPRESENTATIONS

A. I represent that there are no existing assignments or licenses, direct or indirect, of non-dramatic performing
rights in or to the musical work listed above, except to or with the producers, or publisher(s) of this work. If there are assignments or licenses other than with producers, or publisher(s), I will mail attached copies of such assignments or licenses to D’Cohca, LTD and www.recordsongs.us.

B. I have read the articles of the agreement, and agree to be bound by them, as now in effect, and as they may be amended, and I agree to execute agreements in such form and for such periods as the Board of Directors of D’Cohca, LTD and www.recordsongs.us shall have required and shall hereafter require for any accepted members.

C. I represent that I meet the eligibility requirements for membership as set forth herein. I understand that
D’Cohca, LTD and www.recordsongs.us reserves the right to request substantiation of eligibility at any time.

D. I warrant and represent that all of the information furnished in this application is true. I acknowledge that any agreement entered into between D’Cohca, LTD and www.recordsongs.us and me will be in reliance upon the representations contained in this application, and that my membership will be subject to termination if the information contained in this application is not complete and accurate.

* I Agree to the warranties and terms above.


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