Student first name

Student surname

School

Gender

Year Group

Date of birth

Instrumental Teacher

Type of hire you wish to apply for Type of hire you wish to apply forStandard HireEndangered Instrument HireInfant/Elfin/Start Group/Special Project HireEndangered Project Hire (ONLY for pupils who have taken part in 'Endangered Project' lessonsContinuation (ONLY for pupils who have taken part in a school project & continuing using the same instrument)Free Hire (ONLY for 'looked after children')

Instrument required

Instrument size (violin, viola and cello only - teacher will advise size) Instrument size (violin, viola and cello only - teacher will advise size)1/8 size1/4 size1/2 size3/4 size4/4 (full) size

Is this an Exchange (free instrument exchange for change of size, type or repair) Is this an Exchange (free instrument exchange for change of size, type or repair)YesNo

Phone number

Parent/Carer Title (e.g. Mr, Mrs, Dr etc)

Parent/Carer First Name

Parent/Carer Surname

House Number & Street

Second Line of Address

City

Post Code

E-mail address

Declaration Declaration On behalf of the student named above, I apply to MK Music Service to hire an instrument. I agree to pay fees for the instrument termly upon receipt of invoice and will return the instrument by the end of a term if it is no longer required in order to avoid a further term's charge.

Terms and conditions - I have read the terms and conditions and agree to return the instrument in good condition to MK Music Service if membership of an ensemble should cease or lessons stop Terms and conditions - I have read the terms and conditions and agree to return the instrument in good condition to MK Music Service if membership of an ensemble should cease or lessons stop Terms and conditions