Write an introduction stating your name, your band's name (if applicable) and to whom you are granting permission to use your music. State what musical format you are allowing the grantee permission to use, such as only audio recordings, but not videos.
Write a paragraph outlining what fees, if any, you are expecting to be paid for the use of your music.
Write a paragraph stating that you are the owner of the music, own the only copyright, have the sole right to grant use of the music and are not granting ownership of your material, only use.
State explicitly how and under what circumstances you are allowing the grantee to use your music. For instance, "Band X will allow grantee use of 25 second clips of Song X in a radio advertisement for the purposes of advertising Band X's appearance at the X Music Festival."
Create lines for your printed name, signature, title and date. Create lines for the grantee's printed name, signature, title and date. Write a statement that the signatures of both parties create a binding agreement. (Reference 2)