New School of Music "Online Prices. In Store Service."

Auto-Pay gives you the ability to have your payments automatically deducted from a major credit card or a debit card. By entering the card information below, you are only acknowledging that you would prefer Auto-Pay. You will have the opportunity to review the rental agreement in our store before agreeing to Auto-Pay.

Please complete the information below to reserve your instrument and director required accessories online to avoid the long waits during our busiest time of the year. Once your information has been processed you will be e-mailed a confirmation of your reservation and the time your instrument and accessories will be available. Reserved instruments will be held for 48 HOURS from the time you receive an e-mailed confirmation of instrument availability for pickup.
About Your Instrument:

Location for Pick-up
What Band Instrument would you like to rent?
What Orchestra Instrument would you like to rent?

Director Recommended Books and Accessories:

	Instrument Maintenance Kits - 20% off! Flute $10.80 Clarinet $13.20Oboe $18.80 Saxophone $17.20Trumpet $14.80 French Horn $17.20Trombone $16.40 Low Brass $13.20Orchestra Polishing Kit $7.60 None
	Deluxe Folding Music Stand & Heavy-Duty Nylon Bag Sale Price $9.95 (regular price $17.95) Black None
	Required Music Books Standard of Excellence Enhanced $9.95 ($10.45 French Horn & Percussion) Essential Elements 2000 + DVD $7.95 ($14.95 Percussion) Accent on Achievement $7.95 ($10.95 Percussion) Yamaha Band Student $5.95 A Fresh Approach - Mallets $14.95 A Fresh Approach - Snare $16.95 None

List other Books or Accessories needed below. Please be as specific as possible.



Applicant Information:

Applicant (Parent/Guardian) Name
At what email can you be reached?
At what phone number may we call you?	( ) -
How do you prefer to be contacted?	Phone Email No preference
Home Address
City
State
Zip
Social Security Number
Date of Birth
Driver's License Number
Place of Employment
Work Telephone	( ) -
Employment Address
City, State, Zip

Spouse:

Spouse's Name
Social Security Number
Home Telephone Number
E-mail
Date of Birth
Place of Employment
Work Telephone	( ) -
Employment Address
City, State, Zip

About the Student:

Student's Name
School
Grade

Auto Pay:

Auto-Pay gives you the ability to have your payments automatically deducted from a major credit card or a debit card. By entering the card information below, you are only acknowledging that you would prefer Auto-Pay. You will have the opportunity to review the rental agreement in our store before agreeing to Auto-Pay.
Card Type
Card Number
Expiration