Copyright Registration Checklist
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Name/Title of the work: __________________________________[the work]
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Type of work: audio, visual, written, etc._________________________
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What are you claiming rights to: (e.g. text, audio, visual, lyrics, sound, etc.)
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Provide the following for all creators, authors and/or contributors of the work: name(s), address(es),telephone number(s), and citizenship
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In what year was creation completed? Is the work still being modified?
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What is the date of first publication of the work? Where was the work published?
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Is the work based upon a derivative or does it incorporate any preexisting work(s). If so, please explain
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If yes to the question above, please describe what was added to or changed to make this work