I will pay fee with:

xx →  ☑  $29.95 - Credit/Debit
or →  ☐ $29.95 - PayPal

A.  Registrar:  (person submitting material)  

Street Address/Apt:   City-State-Zip-Country:  

B.  Your email address:    This is optional, but does offer you an extra layer of identification. Last 4 of Soc. (or other ID):  

C.  Song titles & composers:

Title #1:

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Title #2:

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Title #3:

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Title #4:

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select one →         I will:    upload       mail       not sure      my material to you.   

•  If uploading, you will be sent to our Uploader — and your Affidavit emailed instantly.
•  If mailing, please follow mail-in directions and use forms here.
•  If not sure, that's okay, please continue...