Band Instrument Rental Application

Step 1 of 5 - Student Information

Student Name*
Student Grade*
Student School*
School Building*
Don't see your school listed? We are constantly looking at ways to expand and grow our business so contact us and we'll see what we can do about adding your school to the list of serviceable schools! Contact Us

Have you rented a band instrument from us before?
- Yes
- No
Applicant Full Name*
Email Address*
Enter Email Confirm Email
Applicant Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Is "Home Phone" a Mobile Phone?
- Yes
- No
Mobile Phone
Applicant Date of Birth*
Applicant Social Security Number*
Employer*
Employer Phone Number*
Closest Relative Not Living With You (Full Name)*
Closest Relative Phone #*
Relation
Authorization Agreement
Do you (Primary Applicant) agree to the terms of the Authorization Agreement?*
By clicking I Agree, you agree to the rental application Authorization Agreement viewable above.
- I Agree

Will you be using a co-applicant?*
- Yes
- No
Co-Applicant Full Name*
Is the address, email, and primary phone number the same as the primary applicant?*
- Yes
- No
Email Address*
Enter Email Confirm Email
Co-Applicant Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone Number*
Co-applicant Secondary Phone Number
Co-Applicant Date of Birth*
Co-Applicant Social Security Number*
Employer*
Employer Phone Number*
Authorization Agreement
Do you (Co-applicant) agree to the terms of the Authorization Agreement?*
By clicking I Agree, you agree to the rental application Authorization Agreement viewable above.
- I Agree

Instrument*
Instrument*
Standard of Excellence Method Book*
This is the method book required for lessons at your school.
St. Marys Standard of Excellence Method Book*
This is the method book required for lessons at your school.
Ed Sueta Premiere Performance Method Book*
This is the method book required for lessons at your school.
Punxsutawney Method Book*
This is the method book required for lessons at your school.
Tradition of Excellence Method Book*
This is the method book required for lessons at your school.
Sound Innovations Method Book*
This is the method book required for lessons at your school.
Measures of Success Method Book*
This is the method book required for lessons at your school.
Brockway Method Book*
This is the method book required for lessons at your school.
Essential Elements Method Book*
This is the method book required for lessons at your school.
Making Music Matter*
This is the method book required for lessons at your school.
Cranberry Method Book*
This is the method book required for lessons at your school.
Elk County Catholic Method Book*
This is the method book required for lessons at your school.
Indiana Method Book*
This is the method book required for lessons at your school.
Penns Manor Method Book*
This is the method book required for lessons at your school.
Recommended Clarinet Accessory Packages*
Clarinet accessory packs -

Value Package: (Mouthpiece Cleaner and Care Kit

Better Value Package: (Value Pack + Music Stand)

Best Value Package: (Better Value Pack + Pad Saver)
Recommended Flute Accessory Packages*
Flute accessory packs and their regular prices are as follows:

Value pack includes Mouthpiece Cleaner and Instrument Care Kit.

Better Value Package: Value pack + Folding music stand.

Best Value Package: Better Value Pack + Pad Saver
Recommended Alto Sax Accessory Packages*
Alto Sax accessory packs are as follows:

Value Package: (Mouthpiece Cleaner and Care Kit)

Better Value Package: (Value Pack and Music Stand)

Best Value Package: (Better Value Pack and Pad Saver)
Recommended Tenor Sax Accessory Packages*
Tenor Sax accessory packs and their regular prices are as follows:

Value Package: (Mouthpiece Cleaner and Care Kit)

Better Value Package: (Value Pack + Music Stand)

Best Value Package: (Better Value Pack + Pad Saver)
Recommended Trumpet Accessory Packages*
Trumpet accessory packs and their regular prices are as follows:

Value Package: (Mouthpiece Cleaner and Care Kit)

Best Value Package: (Value Pack + Music Stand)
Recommended Trombone Accessory Packages*
Trombone accessory packs and their regular prices are as follows:

Value Package: (Mouthpiece Cleaner and Care Kit)

Best Value Package: (Value Pack and Music Stand)
Recommended French Horn Accessory Packages*
French Horn accessory packs and their regular prices are as follows:

Value Package $22.85: (Mouthpiece Cleaner $3.99 and Care Kit $18.86)

Best Value Package $39.84: (Value Pack $22.85 and Music Stand $16.99)
Recommended Baritone Accessory Packages*
Baritone accessory packs and their regular prices are as follows:

Value Package $22.85: (Mouthpiece Cleaner $3.99 and Care Kit $18.86)

Best Value Package $37.97: (Value Pack $20.98 and Music Stand $16.99)
Recommended Percussion Accessories*
Recommended Violin/Viola Accessories*
Clarinet Reeds*
For Clarinet, Alto Sax, and Tenor Sax, reeds are needed for the instrument to play. Our rental instruments include 1 reed. Beginners go through reeds quickly and we recommend starting with at least a 3 pack.
Alto Sax Reeds*
For Clarinet, Alto Sax, and Tenor Sax, reeds are needed for the instrument to play. Our rental instruments include 1 reed. Beginners go through reeds quickly and we recommend starting with at least a 3 pack.
Tenor Sax Reeds*
For Clarinet, Alto Sax, and Tenor Sax, reeds are needed for the instrument to play. Our rental instruments include 1 reed. Beginners go through reeds quickly and we recommend starting with at least a 3 pack.
Total
$0.00

Credit Card Type*
Credit Card Number*
Expiration Date (Month/Year)*
Billing Zip Code*
3 Digit CVV Code on Back of Card*
Monthly Auto Pay Pay Agreement*
Monthly Automatic Payments are required for our band instrument rental program.
- I Accept
Delivery Options*
Delivery Notes
example: "For Fall Delivery" or "Summer Program" *please note, Summer Program delivery may not be available, we will notify you if the instrument must be picked up from us.*
Total
(6% PA sales tax will be added on to the total and payment will be processed after the application is approved)
$0.00
By submitting this application, you agree to the terms of the Band Instrument Rental Purchase Agreement that can be read here: Terms and Conditions.