Date Form Submitted: *APPLICATION FORM- BAR/CLUB/RESTAURANT:In this form, A User means a person or company or entity liable to pay royalties for the use of Copyright Protected Works in the Territory of Botswana. Society means COSBOTS, the Copyright Society of Botswana. Copyright Protected Works means works protected under the Copyright & Neighbouring Rights Act of 2000 Cap 68:02.Applicant/User’s Details:Name of your Company or Organization: *Trading Name: *Address: *Address Line 1CityState / Province / RegionContact Number Work:Mobile Number: *Fax:Email:Website / URL:Name of signing officer: *Vat number:Designation: *Application of MusicType of Entity: *BarClub RestaurantPlease tick appropriate options: *DJTVJukeboxSquare meters: *In addition to the above, do you plan to host an event/s where music is being played? If yes complete the following;Event details:Name:Date:Venue:Expected Attendance:Is admission fee charged or not charged?Brief Terms and Conditions:1. Royalties together with applicable taxes are payable by the user to the Society. 2. The information provided by the user in this Form shall aid the Society in calculating appropriate royalties payable by the user to the Society and an invoice issued in that regard. 3. Royalties are calculated in line with the Society’s Applicable TariffsSignature Clause: *Please TickBy signing below, you agree that: (i)You have read, understood, and accept the above recorded terms (ii) All information you have provided is correct and complete (iii) You have authority to sign on behalf of the licenseeEmailSubmit
