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Rental
Questions? 585-671-2020
String Instrument Lease Renewal
Lease: Violin
Violin Lease Application
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School Year Lease Price:
$149.00
School Year Repair Coverage:
Included
Violin Size:
Please select an option
*
1/10
1/8
1/4
1/2
3/4
4/4
Not Sure?
Contact your music teacher or stop in for measurement.
School Lessons Start Date
*If your child is signed up for summer school lessons, please select "Summer Lessons" below and provide the first lesson date.
**Starting dates are typically provided by your music teacher either in a paper information handout/flyer or in an email.
*
Beginning of upcoming school year (Fall semester)
Summer School Lessons (provide start date below)
Student Information:
Name: Last, First, Middle Initial
*
Grade Attending in Fall
*
Music Teacher's Name
*
School District
*
School Building
*
Home Address (if different)
Primary Account Contact:
Name: Last, First, Middle Initial
*
Relation To Student
*
Home Street Address
*
City / Town
*
Zip Code
*
Phone
*
Email
*
Driver's License Number & State
*
(example: 123-456-789 NY)
Employer Name
*
(Full business name, no abbreviations or acronyms. If self-employed, please list full name of business)
Current Position
*
Employer Street Address
*
City / Town
*
State / Zip Code
*
Work Phone or Cell
*
Work Email
Secondary Account Contact:
If Home Address information is same as Primary, type "SAME" in Address fields.
Name: Last, First, Middle Initial
*
Relation To Primary
*
Home Street Address
*
City / Town
*
Zip Code
*
Phone
*
Email
*
Driver's License Number & State
(example: 123-456-789 NY)
Employer Name
*
(Full business name, no abbreviations or acronyms. If self-employed, please list full name of business)
Current Position
*
Work Phone or Cell
*
Accessories (Please select items for delivery with your instrument)
Shoulder Sponge
Shoulder Sponge (+$4.50)
Raises the instrument off the shoulder for better playing position and comfort.
Music Stand
Music Stand (+$16.95)
Essential for proper posture while practicing at home.
Lesson Book(s)
Click Your Required Lesson Book(s)
Unsure At This Time
Solo Time for Strings Bk. 1 ($5.99)
Essential Elements For Strings Bk 1 ($12.99)
Suzuki Vol. 1 Bk. 1 ($14.99)
String Explorer Bk. 1 ($11.99)
Payment Information:
Name On Card
*
Card Type
*
Visa
Mastercard
Discover
Card Number
*
(example: 1234-1234-1234-1234)
Expiration Date
*
(example: 09/27)
3-Digit Security Code
*
*
IMPORTANT!
PLEASE READ TERMS AND CONDITIONS FULLY BEFORE AGREEING
LEGAL INFORMATION -
NYS PENAL LAW REGARDING NON-PAYMENT AND REFUSAL TO RETURN RENTAL PROPERTY
I read, understand, & agree:
Terms and Conditions
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*
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Make
Model
Serial #
Date Filled
