Company Name

Name *

Email address *

What is the intended use of the image ? *

What will the image be used for ? *

How many times will the image be used? *

Will the image be used in multiple locations or platforms *

For how long do you need the license *

Where will the image be used ? *

Do you intend to modify or edit the image in any way? *

If no what kind of modifications are planned?

Do you require exclusive rights to the image, or is a non-exclusive license sufficient? *

What is your budget for licensing the image? *

Are there any additional costs you anticipate *

Are there any specific legal or compliance requirements you need to meet?

Do you need any warranties or indemnities from the photographer?

Do you require any additional services, such as custom editing or exclusive shoots?