Publisher - Copyghana

Data on Organisation

Name of Organisation *

Tax Identification Number *0 / 11

Location Address *

Postal Address

Email *

Phone Number *0 / 10

Mode of Royalty Payment *

Bank Account Name *

Bank Account Number *

Bank Branch *

Mobile Money Network *

Mobile Money Phone Number *

Mobile Money Account Name *

RIGHTSHOLDER AFFILIATION AGREEMENTbetween: CopyGhana – and – your organisation

Date *

Contact Person *Name

Designation of Contact Person *

Phone Number of Contact Person *0 / 10

Address of Contact Person *