Name of Work you wish to rent/Oeuvre que vous voulez louer:

Your e-mail address/votre addresse mel:

Your name/Votre Nom:

Your telephone number/Votre numéro de téléphone:

Name of Performing Organisation/nom de l'ensemble/association/organisateur:

How Many Performances?/combien de representations?:

Recorded for Radio/Television?/enregistrements pour Radio/Télévision?:

We will confirm your order by telephone or fax and bill you for the costs of the rental.

All payments must be received before shipment.