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Seeking "A Child My Choice" by Dirksen

Location: New York, USA
Item: "A Child My Choice"
Composer/Arranger/Edition: Richard Dirksen
Starting: October/November
For: Not long at all
Copies: 1
Willing to rent: No
Hello Choral Experts,
The church choir in which I sing is interested in performing "A Child My Choice" by Richard Dirksen, published in 1957 by H.W. Gray Music Company. The piece is now out of print, so I am trying to complete an application for a copyright license through Alfred (current owner of H.W. Gray). However, it looks as though I need an actual copy of the piece in order to properly fill in the application, so I can supply the exact wording of the copyright notice.
My questions are:
-Does anyone have a copy of this piece?
-If so, would you be willing to send me the exact wording of the copyright notice?
-And if my license is approved to make copies, may I use your sheet music to do so?
Thanks in advance to anyone who can help out!
Adam Judd